Treatment of acute allograft rejection with high doses of corticosteroids.

Sixty-four rejection crises in 55 kidney transplant patients were treated with high doses of corticosteroids, either 1) prednisone, administered orally in doses ranging between 150 and 600mh/day;2)methylprednisolone, administered i.v. in doses of 0.5 to 1 g/day (total dose: 2 to 8 g); or 3) methylprednisone administered i.v. in the same dosage in combination with heparin 5000 U/day. Acute rejection was reversed successfully in 60% of the crises without any apparent difference between the three treatment groups. Nineteen patients died from steroid-related complications. A total methylprednisolone dosage exceeding 3 to 5 h apparently was not accompanied by a sufficiently improved therapeutic response to warrant the high risk of such treatment.