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lüll European best practice guidelines for renal transplantation Section IV: Long-term management of the transplant recipient IV 3 1 Long-term immunosuppression Late steroid or cyclosporine withdrawal äNephrol Dial Transplant 2002[]; 17 Suppl 4 (ä): 19-20A. In order to reduce or avoid long-term serious adverse effects of corticosteroids, such as bone fractures, diabetes mellitus, arterial hypertension, osteoporosis and eye complications, steroid withdrawal should be considered. B. Steroid withdrawal is safe only in a proportion of graft recipients and is recommended only in low-risk patients. The efficacy of the remaining immunosuppression should be considered. C. After steroid withdrawal, graft function has to be monitored very carefully because of the risk of a delayed but continuous loss of function due to chronic graft dysfunction. In the case of functional deterioration or dysfunction, steroids should be re-administered. D. Cyclosporine withdrawal might be considered in order to ameliorate nephrotoxicity, arterial hypertension, lipid disorders and hypertrichosis. This can be carried out with no significant long-term risk of progressive graft loss. The efficacy of the remaining immunosuppression should be considered. After cyclosporine withdrawal, careful monitoring for acute rejection is recommended.|Adrenal Cortex Hormones/*adverse effects[MESH]|Cyclosporine/*adverse effects[MESH]|Humans[MESH]|Immunosuppressive Agents/*adverse effects[MESH]|Kidney Transplantation/*adverse effects[MESH]|Kidney/drug effects[MESH] |