He stopped all immunosuppressive drugs, including cortisone, in a kidney-transplant patient six years after the transplant; after six weeks the transplanted kidney worked more efficiently with a better GFR (presented as a success of the Tayebat system).
Original statement
هي كلمه واحده انا هقولها معايا حاله زرع ك بطلت لها ادويه مثبطات المناعه بتاعتها الكورتيزون بعد ست سنين من الزرع بتاعها والحمد لله بعد شهر ونص الكليه المزروعه بتعمل بكفاءه اكتر الكليات من احسن والجي اف ار احسن بفضل الله
verbatim according to source. Translation by the project; the Arabic wording is authoritative.
Translation
He stopped all immunosuppressive drugs, including cortisone, in a kidney-transplant patient six years after the transplant; after six weeks the transplanted kidney worked more efficiently with a better GFR (presented as a success of the Tayebat system).
Origin
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- Dr.D Clinics - Diaa Al Awady is live! الام الذبحة و التهاب الأعصاب الطرفية (Open source)
- Published
- 18 February 2025
- Timestamp
- 0:18:45 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
- Attribution uncertainty
- Transcript is YouTube CC or machine-generated (no timestamps); wording may contain speech-recognition errors. Speaker attribution within live streams/podcasts is not marked in the transcript; the excerpt was judged to be Elawady's own speech from context. Recurrence = number of archive transcripts matching the keyword pattern ['زرع|زرعه|المزروعه', 'مثبطات|بروجراف|ماي فورتك|ادويه المناعه|دوا الزرع'] (approximate; includes re-uploads/clips; 11 distinct text passages).
- Claimed mechanism
Not stated in this excerpt.
- Claimed health effect
Improved function of a transplanted kidney after stopping immunosuppression.
- Population concerned
Kidney-transplant recipients.
- Geographic restriction by Elawady
none found; he does not limit this statement to a country or to a production system
Diverging source versions
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- انت نازل الارض تجمع حسنات والا تقضي عقوبه ؟ #ضياء_العوضي #الحقيقة_والسراب (Open source)
- Published
- 16 December 2025
- Timestamp
- not available (transcript has no timings)
- Attribution uncertainty
- Further video in which the same statement recurs; no excerpt recorded. Archive transcript without timestamps.
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- Dr Diaa Al Awady د ضياء العوضي is live!لايف الخميس ❤️❤️❤️ (Open source)
- Published
- 30 January 2026
- Timestamp
- not available (transcript has no timings)
- Attribution uncertainty
- Further video in which the same statement recurs; no excerpt recorded. Archive transcript without timestamps.
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- Dr Diaa Al Awady د ضياء العوضي is live!تجويع الخلايا من السكر الكظرية (Open source)
- Published
- 26 October 2025
- Timestamp
- not available (transcript has no timings)
- Attribution uncertainty
- Further video in which the same statement recurs; no excerpt recorded. Archive transcript without timestamps.
Scientific assessment
False – The statement contradicts the robust evidence.
Certainty of evidence: moderate – Further research may still affect the assessment.
1. What was claimed?
He reports that he stopped all immunosuppressants and cortisone in a kidney-transplant recipient six years after transplantation and that six weeks later the graft worked better.
2. What is demonstrably correct?
Corticosteroids can be withdrawn in selected recipients when other immunosuppressants continue: in a blinded RCT, early steroid withdrawal with continued tacrolimus and MMF gave similar 5-year graft survival and function and better metabolic outcomes, though with more mild acute rejection (17.8% vs 10.8%) (I-INTB-10). He also said himself that he did not know what would happen. A Cochrane review updated in 2026 (53 trials) found no clear difference in graft loss in the first year when steroids were stopped or avoided while other drugs continued (I-SRC-101). A small number of recipients do keep a working kidney without any drugs (operational tolerance), but this is rare, cannot be predicted by routine tests, and about 30% of such patients in a European cohort later showed slow loss of function (I-SRC-118).
3. What is wrong or exaggerated?
Presenting this case as a success is not justified. Not taking immunosuppressants is common and is associated with about seven times higher odds of graft failure; a median 36% of graft losses followed prior nonadherence (I-INTB-09). Rejection can develop months after stopping drugs, so six weeks says little. A short-term rise in GFR after stopping calcineurin inhibitors (tacrolimus, ciclosporin) is expected: the KDIGO guideline notes that randomised trials of complete calcineurin-inhibitor withdrawal show some small benefit in graft function but significantly more acute rejection (I-INTB-11), so a better GFR does not prove the graft is safe. In the CTOT-09 trial, stopping tacrolimus even in low-risk recipients led to rejection in 4 of 14 and new donor-specific antibodies in 5 of 14, and the trial was stopped (I-SRC-102). Immunosuppression and graft monitoring are part of standard transplant care (I-INTB-11).
4. What remains unclear?
What happened to this patient later is unknown.
5. Which studies support it?
I-INTB-10 and I-SRC-101 (only for steroid withdrawal with continued immunosuppression); I-SRC-118 (rare operational tolerance; selected survivors).
6. Which studies contradict it?
I-INTB-09, I-INTB-11, I-SRC-102.
7. What applies to Germany and Europe?
Transplant centres in Europe follow KDIGO-type guidance; changes in immunosuppression are made by the transplant team.
8. What is known about Egypt?
The same applies in Egypt; graft loss means a return to dialysis.
9. What practical conclusion is appropriate?
Never stop transplant medicines without the transplant team. Steroid reduction is sometimes possible, but only under specialist supervision with monitoring.
Assessment details
- Rationale for certainty of evidence
The single case cannot be verified and six weeks is far too short to judge graft survival. Systematic review evidence shows that not taking immunosuppressants raises the odds of graft failure about sevenfold (I-INTB-09). Complete withdrawal has not been tested in randomised trials (it would be unethical), so certainty is moderate rather than high. Since the last review, a randomised trial (CTOT-09, I-SRC-102) showed that stopping only tacrolimus in carefully selected low-risk recipients caused rejection or new donor-specific antibodies in about a third, and the KDIGO guideline text confirms that RCTs of calcineurin-inhibitor withdrawal show a small gain in graft function but significantly more acute rejection.
- Source quality
Machine transcript of a live stream; wording may contain recognition errors; meaning checked in context. Anecdote; no medical records shown.
- Regional transferability
Universal transplant immunology.
- Individual exceptions
A small minority of recipients may become tolerant of the graft (general transplant knowledge, not sourced here); this cannot be predicted without specialist testing.
- Regional scope of the claim
- general (biological/medical)
- Last reviewed
- 26 October 2026 provisional
Scientific evidence in detail
Scientifically refuted – High-quality evidence shows the opposite, or the claim contradicts well-established physiology.
Research question: In kidney-transplant recipients several years after transplantation, does stopping all immunosuppressive drugs (including corticosteroids) preserve or improve graft function compared with continuing maintenance immunosuppression?
Research question in detail (PICO)
- Population
- Kidney-transplant recipients on maintenance immunosuppression (years after transplantation)
- Intervention or exposure
- Withdrawal of all immunosuppressants and corticosteroids (or of single key drugs)
- Comparison
- Continued maintenance immunosuppression
- Geographic scope
- universal biology; transplant care standards are international and apply in Egypt
- Outcomes
- Acute rejection
- De novo donor-specific antibodies
- Graft loss / return to dialysis
- GFR (short and long term)
Study results as reported by the authors. Our assessment follows below.
What speaks for the claim?
A few kidney recipients keep working kidneys without drugs
Brouard S et al.. Am J Transplant 2012 · PMID 22974211 · DOI 10.1111/j.1600-6143.2012.04249.x Case series / case reportabstract checkednewly addedA European cohort of 27 kidney recipients who kept working grafts after stopping all immunosuppression.
- Actual result
- 19 of 27 stable at mean 9 ± 4 years; 30% slowly deteriorated; DSA-associated injury in half of biopsied patients.
- Methodological quality
- low (selected survivors, no denominator)
- Relevance
- direct for the existence of rare tolerance
- Limitations
- Counts only successes; cannot estimate how often stopping is tolerated.
Stopping steroids after a kidney transplant while other anti-rejection drugs continue
Oliveras L et al.. Cochrane Database Syst Rev 2026 · PMID 42187003 · DOI 10.1002/14651858.CD005632.pub4 Meta-analysisabstract checkednewly addedCochrane 2026: steroid withdrawal or avoidance while other drugs continue.
- Actual result
- Graft loss <=1 y withdrawal RR 1.19 (0.72-1.96); BPAR avoidance RR 1.58 (1.11-2.25); less post-transplant diabetes.
- Methodological quality
- high (Cochrane, 53 RCTs; low-certainty evidence)
- Relevance
- indirect: only steroids stopped, other drugs continued
- Limitations
- Does not test stopping all drugs.
What speaks against the claim?
Stopping tacrolimus after kidney transplant caused rejection
Hricik DE et al.. J Am Soc Nephrol 2015 · PMID 25925687 · DOI 10.1681/ASN.2014121234 Randomised controlled trialabstract checkednewly addedCTOT-09 RCT: tacrolimus weaned in carefully selected immunologically quiescent recipients.
- Actual result
- Stopped early: acute rejection 4/14, de novo DSA 5/14 in the withdrawal arm.
- Methodological quality
- moderate (randomised, small, stopped early)
- Relevance
- direct: withdrawal of the key drug years-scale after transplant
- Limitations
- Small; one drug withdrawn.
Skipping transplant drugs often leads to losing the kidney
Butler JA et al.. Transplantation 2004 · PMID 15021846 · DOI 10.1097/01.tp.0000110408.83054.88 Meta-analysisabstract checkedSystematic review of non-adherence to immunosuppressants.
- Actual result
- Non-adherence associated with about sevenfold odds of graft failure; median 36% of graft losses preceded by non-adherence.
- Methodological quality
- moderate (observational synthesis)
- Relevance
- direct for stopping drugs outside medical supervision
- Limitations
- Observational.
International guideline for kidney-transplant care
KDIGO Transplant Work Group. Am J Transplant 2009 · PMID 19845597 · DOI 10.1111/j.1600-6143.2009.02834.x Guideline / position statementabstract checkedKDIGO 2009 transplant guideline (full PDF read for chapter 3).
- Actual result
- Suggests CNIs and prednisone be continued rather than withdrawn (2B/2C); RCTs of complete CNI withdrawal (8 RCTs, 1891 patients) show a small benefit in graft function but significantly increased acute rejection.
- Methodological quality
- guideline, GRADE-based
- Relevance
- direct
- Limitations
- 2009; update pending.
What does the overall evidence say?
Editorial assessment based on the studies above – not itself a study result.
Which position is better supported?
Continuing maintenance immunosuppression; only supervised steroid withdrawal in selected patients is supported.
Why some studies weigh more
Randomised data (CTOT-09; CNI-withdrawal RCTs summarised by KDIGO; Cochrane steroid review) and the non-adherence synthesis outweigh a single unverified anecdote with six weeks of follow-up. The tolerance cohort shows rare exceptions but counts only survivors.
Is a causal relationship established? Probable Randomised withdrawal of a single key drug caused rejection and antibody formation; observational data link stopping drugs to graft failure. Complete withdrawal of all drugs has not been randomised (unethical), so causal evidence is from partial withdrawal plus consistent observational data.
Remaining uncertainty
Long-term outcome of the patient described is unknown; rare operationally tolerant recipients exist but cannot be identified reliably in advance.
Justified conclusion
Stopping all immunosuppression is expected to cause rejection and graft loss in most recipients. A rise in GFR shortly after stopping calcineurin inhibitors is a known drug effect (KDIGO: small benefit in graft function with CNI withdrawal) and does not show safety.
Why do studies seem to disagree?
No real conflict: steroid-withdrawal trials (I-SRC-101, I-INTB-10) kept tacrolimus/ciclosporin and mycophenolate; tolerance cohorts (I-SRC-118) select successful cases; CTOT-09 and non-adherence studies address withdrawal of the main drugs. They answer different questions.
Does this depend on the country?
- General biological effects
- Transplant immunology is universal.
- Eating habits
- Not diet-related.
- Origin of the food
- Not applicable.
- Contaminants
- Not applicable.
- National production conditions
- Not applicable.
- Legal rules
- Immunosuppressants are prescription medicines; changes are made by transplant teams in Egypt and Europe.
- Actual monitoring data
- No Egyptian registry data on withdrawal outcomes found.
A regional difference that changes the conclusion is not supported by robust data.
Statistical re-check
- Wilson 95% CI for event rates in withdrawal arm – Rejection 4/14 = 28.6% (11.7%-54.6%); DSA 5/14 = 35.7% (16.3%-61.2%) recalculated
- Log-symmetry of RR CIs (RR vs OR wording correct: Cochrane reports RR) – Geometric midpoints equal reported RRs (1.58, 1.41, 1.19, 0.61); consistent recalculated
Certainty of the overall evidence (GRADE, simplified)
- Main outcome
- Graft rejection/loss after withdrawal of maintenance immunosuppression
- Starting level
- high (randomised trials)
- Reasons for downgrading
- indirectness: complete withdrawal of all drugs not randomised; evidence from single-drug withdrawal
- imprecision: small CTOT-09 arm
- Reasons for upgrading
- large effect (sevenfold odds of graft failure with non-adherence; trial stopped for harm)
- Result
- moderate
Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.
Clinical guidelines and official statements checked
- KDIGO: KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients (2009) · Original publication
Rec. 3.2: suggest that CNIs be continued rather than withdrawn (2B) and that prednisone used beyond the first week be continued rather than withdrawn (2C). Background: RCTs of complete CNI withdrawal (8 RCTs, 1891 patients) show some small benefit in graft function but significantly increased acute rejection without clear graft-survival benefit; steroid withdrawal more than 3 months after transplantation increases acute rejection. - KDIGO: Guideline landing page (Care of Kidney Transplant Recipients) (2009) · Original publication
Confirms the 2009 guideline is the current KDIGO transplant-recipient guideline listed; no update text on the page.
Search strategy
Documented literature searches for this review (search strings in the original database syntax).
| Database | Date | Search | Looking for | Hits | Included |
|---|---|---|---|---|---|
| Europe PMC | 26 October 2026 | ("operational tolerance" OR "spontaneous tolerance") AND kidney transplant AND (immunosuppression withdrawal OR "drug-free") | supporting evidence | 709 | |
| Europe PMC | 26 October 2026 | (immunosuppression withdrawal OR "tacrolimus withdrawal" OR "calcineurin inhibitor withdrawal") AND kidney transplant AND (rejection OR "donor-specific antibod*") AND (randomized OR trial) | contradicting evidence | 12115 | |
| Europe PMC | 26 October 2026 | (steroid withdrawal OR steroid avoidance) AND kidney transplant AND "Cochrane Database Syst Rev" | both directions | 146 | |
| PubMed | 26 October 2026 | tacrolimus withdrawal immune quiescent kidney transplant | contradicting evidence | 1 | |
| PubMed | 26 October 2026 | operationally tolerant kidney transplant recipients immunosuppression discontinuation cohort | supporting evidence | 0 | |
| Europe PMC | 26 October 2026 | TITLE:"operationally tolerant" AND kidney | supporting evidence | 8 | |
| Europe PMC | 26 October 2026 | (nonadherence OR non-adherence) AND immunosuppress* AND kidney transplant AND (graft loss OR graft failure) AND (cohort OR systematic review) AND PUB_YEAR:[2015 TO 2026] | contradicting evidence | 3309 | |
| PubMed | 26 October 2026 | natural history of clinical operational tolerance after kidney transplantation | supporting evidence | 5 | |
| KDIGO website | 26 October 2026 | https://kdigo.org/guidelines/transplant-recipient/ (guideline page and full PDF) | guidelines | 1 | |
| Europe PMC | 26 October 2026 | kidney transplant AND "operational tolerance" AND (prevalence OR "natural history" OR registry) | supporting evidence | 178 |
Open questions
Biomarkers that could identify the rare operationally tolerant recipient.
How deeply was this checked?
6 linked studies: 0 checked in full text (0 of them with a structured risk-of-bias assessment), 6 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.
Last scientific review: 26 October 2026
History of the verdict
- 25 October 2026 · Phase 1 · Initial assessment: False (moderate)
- 26 October 2026 · Phase 4 (systematic evidence review) · Re-examined with extended evidence; verdict unchanged: False (moderate)
New randomised (CTOT-09) and Cochrane 2026 evidence and the KDIGO full text strengthen the existing verdict and explain the reported GFR rise as a known CNI-withdrawal effect. Complete withdrawal has still not been randomised, so certainty stays moderate.
New sources: I-SRC-101 I-SRC-102 I-SRC-118
In plain language
Dr. Elawady described one kidney-transplant patient whose anti-rejection drugs he stopped, saying the kidney worked better six weeks later. One case cannot be checked and six weeks is far too short. Studies show that people who do not take their anti-rejection drugs are much more likely to lose the new kidney. Doctors can sometimes stop cortisone, but only while other anti-rejection drugs continue. Stopping everything is risky.
Studies on this claim
Studies supporting the claim (0)
No studies in this group.
Studies contradicting or limiting the claim (3)
-
Skipping transplant drugs often leads to losing the kidney
Butler JA et al.. Transplantation 2004 · PMID 15021846 · DOI 10.1097/01.tp.0000110408.83054.88Meta-analysisindependent cross-checkabstract checked★ key studyNot taking immunosuppressants was linked to about seven times higher odds of graft failure.
Nonadherence raises graft failure about sevenfold.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Measure impact of nonadherence
- How was the study done?
Systematic review
- How many people, animals or samples were studied?
36 studies
- What was actually found?
Nonadherence common; strongly linked to graft loss
- How large was the observed effect?
about 7-fold odds of graft failure
- What do the results mean in everyday life?
Transplant medicines protect the new kidney; stopping them is a major cause of losing it.
- What are the study's limitations?
Self-report measures; abstract only
- What does it say about Elawady's specific claim?
Contradicts stopping immunosuppression.
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Cannot predict the outcome for one individual patient.
-
International guideline for kidney-transplant care
KDIGO Transplant Work Group. Am J Transplant 2009 · PMID 19845597 · DOI 10.1111/j.1600-6143.2009.02834.xGuideline / position statementindependent cross-checkabstract checkedGives recommendations on immunosuppression and monitoring after kidney transplant.
Immunosuppression is part of standard care.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Guide transplant care
- How was the study done?
GRADE guideline
- How many people, animals or samples were studied?
not applicable
- What was actually found?
Recommendations on immunosuppression
- How large was the observed effect?
not applicable
- What do the results mean in everyday life?
Anti-rejection treatment and monitoring are standard after a kidney transplant.
- What are the study's limitations?
Abstract only
- What does it say about Elawady's specific claim?
Contradicts stopping all immunosuppression.
- Do the results apply to Germany and Europe?
High
-
Stopping tacrolimus after kidney transplant caused rejection
Hricik DE et al.. J Am Soc Nephrol 2015 · PMID 25925687 · DOI 10.1681/ASN.2014121234Randomised controlled trialindependent cross-checkabstract checked★ key studyIn a trial of carefully selected low-risk patients, stopping tacrolimus led to rejection in 4 of 14 and new antibodies in 5 of 14; the trial was stopped.
Withdrawal of only tacrolimus in lowest-risk patients caused rejection or antibodies in about a third.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Test whether low-risk kidney recipients can stop tacrolimus
- How was the study done?
Randomised trial
- How many people, animals or samples were studied?
Living-donor recipients; 14 in the withdrawal arm
- What was actually found?
High rates of rejection and donor-specific antibodies
- How large was the observed effect?
4/14 rejection; 5/14 new antibodies
- What do the results mean in everyday life?
Even stopping one anti-rejection drug can damage the kidney
- What are the study's limitations?
Small; stopped early
- What does it say about Elawady's specific claim?
Contradicts stopping all immunosuppression
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Long-term graft loss rates (trial stopped)
No study in this group is marked as key.
Studies with mixed or unclear results (3)
-
Stopping steroids early after transplant, while keeping other drugs
Woodle ES et al.. Ann Surg 2008 · PMID 18936569 · DOI 10.1097/SLA.0b013e318187d1daRandomised controlled trialindependent cross-checkabstract checkedWith continued tacrolimus and MMF, early steroid withdrawal gave similar 5-year graft survival but more mild rejection.
Steroid withdrawal possible with continued immunosuppression.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Test early steroid withdrawal
- How was the study done?
Blinded RCT
- How many people, animals or samples were studied?
386 recipients
- What was actually found?
Similar graft survival; more mild rejection; better metabolic profile
- How large was the observed effect?
rejection 17.8% vs 10.8%
- What do the results mean in everyday life?
Doctors can sometimes drop cortisone after transplant, but the other anti-rejection drugs stay.
- What are the study's limitations?
Selected patients; abstract only
- What does it say about Elawady's specific claim?
Partly supports dropping cortisone; contradicts stopping all immunosuppressants.
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Cannot conclude that all immunosuppression can be stopped.
-
Stopping steroids after a kidney transplant while other anti-rejection drugs continue
Oliveras L et al.. Cochrane Database Syst Rev 2026 · PMID 42187003 · DOI 10.1002/14651858.CD005632.pub4Meta-analysisindependent cross-checkabstract checked★ key studyAcross 53 trials, stopping or avoiding steroids did not clearly change graft loss in the first year; avoiding steroids slightly raised acute rejection in some regimens.
Supports steroid withdrawal only when other immunosuppressants continue; does not support stopping all drugs.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Find out whether steroids can be left out after a kidney transplant
- How was the study done?
Cochrane review of randomised trials
- How many people, animals or samples were studied?
53 trials, 8317 recipients
- What was actually found?
Similar short-term graft survival; more acute rejection with steroid avoidance unless combined with modern drugs; less post-transplant diabetes
- How large was the observed effect?
BPAR RR 1.58 (avoidance); graft loss RR 1.19 (withdrawal, CI 0.72-1.96)
- What do the results mean in everyday life?
Doctors can sometimes stop cortisone, but only while other anti-rejection drugs continue
- What are the study's limitations?
Low certainty; mostly unblinded trials
- What does it say about Elawady's specific claim?
Supports only steroid withdrawal under specialist care, not stopping all drugs
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Whether stopping all anti-rejection drugs is safe (not studied)
-
A few kidney recipients keep working kidneys without drugs
Brouard S et al.. Am J Transplant 2012 · PMID 22974211 · DOI 10.1111/j.1600-6143.2012.04249.xCase series / case reportindependent cross-checkabstract checked27 rare patients had stable kidneys off drugs, but almost a third later lost function slowly.
Rare operational tolerance exists, but the cohort counts only successes and 30% later deteriorated.
Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Describe patients who tolerate a kidney without drugs
- How was the study done?
Comparison of a rare cohort with other patients
- How many people, animals or samples were studied?
27 tolerant patients
- What was actually found?
Most kept function for years; 30% slowly deteriorated
- How large was the observed effect?
19/27 stable at mean 9 years
- What do the results mean in everyday life?
Such cases exist but are rare and cannot be predicted
- What are the study's limitations?
Only successes counted
- What does it say about Elawady's specific claim?
A rare exception, not a basis for stopping drugs
- Do the results apply to Germany and Europe?
European data
- What can explicitly not be concluded from this study?
How many people who stop drugs keep their kidney
No study in this group is marked as key.
Regional context
Germany / EU
Transplant centres in Europe follow KDIGO-type guidance; changes in immunosuppression are made by the transplant team.
Egypt
The same applies in Egypt; graft loss means a return to dialysis.
What applies in my country?
General scientific assessment
False Stopping all anti-rejection drugs after a kidney transplant is not a success: trials show that even stopping one key drug causes rejection, and a short-term rise in GFR is an expected drug effect.
This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.
References
- Frequency and impact of nonadherence to immunosuppressants after renal transplantation: a systematic review.. Butler JA et al.. Transplantation 2004 · PMID 15021846 · DOI 10.1097/01.tp.0000110408.83054.88
- KDIGO clinical practice guideline for the care of kidney transplant recipients.. KDIGO Transplant Work Group. Am J Transplant 2009 · PMID 19845597 · DOI 10.1111/j.1600-6143.2009.02834.x
- Adverse Outcomes of Tacrolimus Withdrawal in Immune-Quiescent Kidney Transplant Recipients.. Hricik DE et al.. J Am Soc Nephrol 2015 · PMID 25925687 · DOI 10.1681/ASN.2014121234
- A prospective, randomized, double-blind, placebo-controlled multicenter trial comparing early (7 day) corticosteroid cessation versus long-term, low-dose corticosteroid therapy.. Woodle ES et al.. Ann Surg 2008 · PMID 18936569 · DOI 10.1097/SLA.0b013e318187d1da
- Steroid avoidance or withdrawal for kidney transplant recipients.. Oliveras L et al.. Cochrane Database Syst Rev 2026 · PMID 42187003 · DOI 10.1002/14651858.CD005632.pub4
- The natural history of clinical operational tolerance after kidney transplantation through twenty-seven cases.. Brouard S et al.. Am J Transplant 2012 · PMID 22974211 · DOI 10.1111/j.1600-6143.2012.04249.x