Published online Nov 18, 2021. doi: 10.5500/wjt.v11.i11.443
Peer-review started: May 27, 2021
First decision: July 28, 2021
Revised: September 16, 2021
Accepted: November 3, 2021
Article in press: November 3, 2021
Published online: November 18, 2021
Glucocorticoids (GCs) have been the mainstay of immunosuppressive therapy in solid organ transplantation (SOT) for decades, due to their potent effects on innate immunity and tissue protective effects. However, some SOT centers are reluctant to administer GCs long-term because of the various related side effects. This review summarizes the advantages and disadvantages of GCs in SOT. PubMed and Scopus databases were searched from 2011 to April 2021 using search syntaxes covering “transplantation” and “glucocorticoids”. GCs are used in transplant recipients, transplant donors, and organ perfusate solution to improve transplant outcomes. In SOT recipients, GCs are administered as induction and maintenance immunosuppressive therapy. GCs are also the cornerstone to treat acute antibody- and T-cell-mediated rejections. Addition of GCs to organ perfusate solution and pretreatment of transplant donors with GCs are recom
Core Tip: Due to their potent immunosuppressive and anti-inflammatory effects, glucocorticoids (GCs) are widely used in solid organ transplantation (SOT). We review the current status of GC usage in SOT, including the different clinical uses in transplant recipients and donors, new strategies for targeted organ delivery of GCs, and enhan