Background. Despite earlier studies describing the feasibility of steroid weaning in heart transplant patients, themajority of patients\naremaintained on steroid therapy for life.We examined a strategy based on a singlemorning serumcortisol measurement. Methods.\nWe assigned stable posttransplant patients, who were maintained on tacrolimus, mycophenolate mofetil, and corticosteroids, into\none of two groups based on a screening morning cortisol level. Patients with a cortisol < 8 micrograms/deciliter were assigned to a\nââ?¬Å?maintenanceââ?¬Â group and the others were assigned to theweaning group and steroidswere tapered off over 4ââ?¬â??6weeks. Patients were\nmonitored on subsequent office visits for adrenal insufficiency and allograft rejection. Results. Thirty-one patients were enrolled\n(6 patients in the maintenance group and 25 in the steroid-weaning group). Mean follow-up was 10.2 Ã?± 4 years for the weaning\ngroup and 9.0 Ã?± 4.9 years in the maintenance group (
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