In defense of the administration of perioperative steroids in liver transplantation

Reduced post‐operative neutrophil activation in liver transplant recipients suffering from post‐hepatitic cirrhosis

“…In parallel, MPO levels tend toward declining values. In this context, there is growing evidence that a pre‐operative methylprednisolone pulse may attenuate the inflammatory cytokine response (23, 24). Remarkably, MPO levels and unstimulated respiratory burst activity were lower at the third post‐operative day in patients with post‐hepatitic cirrhosis.…”

Adrenal insufficiency

“…Increasingly, transplant centers are using steroid-free immunosuppressant regimens in order to minimize the known risks of steroids such as new onset diabetes, wound infections, and concerns about the risk of recurrent hepatitis C infection in the graft. Therefore, the identification and treatment of AI in the postoperative phase of LT may become increasingly important [49].…”