*Purpose: The risks and benefits of remote steroid wean in heart transplant recipients is unknown. We compared outcomes in patients undergoing early and remote steroid wean after heart transplantation.

*Methods: We performed a retrospective study comparing early vs. late prednisone wean in patients with heart transplantation. Primary outcomes included mortality, graft dysfunction and burden of rejection. Secondary outcomes included change in hemoglobin A1c, LDL cholesterol, triglycerides, T-score dexa-score, body mass index (BMI) before and after the wean. Patients characteristics and outcomes were stratified by early or remote steroid weaning. Differences between early and remote groups were determined by the Chi-square or Fisher’s exact tests for categorical variables and Kruskal Wallis test for continuous variables. All the analyses were performed on Stata version 16.0 (StataCorp LLC, College Station, TX, USA). A p-value of <0.05 was considered statistically significant.

*Results: A total of 63 patients underwent our steroid wean protocol between 2012 and 2017. Outcomes of patients weaned at 1 year (n= 34; median time from transplant= 1.1 years) were compared with those weaned after 2 years (n=29; median time from transplantation= 4.4 years). No significant difference was found between the number of patients successfully weaned in the early group (88.2%) and remote group (79.3%) (p-value 0.33). There were no differences in graft function (p-value 0.08), prevalence of rejection (p-value 0.46) or survival up to 3 years (p-value 0.09) in patients with early as compared with remote wean (table 1). Improvement in metabolic profile was seen in both groups however these were not statistically significant (table 2).

*Conclusions: There were no differences in graft function, prevalence of rejection or survival up to 3 years in patients with early as compared with remote wean.

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