Published online Apr 18, 2021. doi: 10.5500/wjt.v11.i4.99
Peer-review started: November 22, 2020
First decision: January 11, 2021
Revised: January 22, 2021
Accepted: March 19, 2021
Article in press: March 19, 2021
Published online: April 18, 2021
Core Tip: Prolonged steroid therapy was associated with many complications that ranged from cosmetic changes to life-threatening increase in cardiovascular risk profile. The utilisation of antibody induction, together with calcineurin inhibitors maintenance immune suppression, had markedly reduced the incidence of acute rejection. The improved rate of acute rejection encouraged different transplant centres to adopt new steroid-free protocols, especially in fragile cases with multiple comorbidities. Variable steroid-free approaches were tried. We aim to explore the safety and efficacy of various steroid-free protocols by comparing each different modality with the conventional triple immune suppression.