Analysis of the Selected Biochemical Parameters of Liver and Kidney Function in Children of Mothers After Liver Transplantation

Czaplinska, Natalia; Kociszewska-Najman, Bozena; Schreiber-Zamora, Joanna; Wilkos, Ewa; Drozdowska-Szymczak, Agnieszka; Borek-Dzieciol, Beata; Pietrzak, Bronisława; Wielgoś, Mirosław

doi:10.1016/j.transproceed.2014.09.059

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Those results need further studies, especially taking into account the potential nephrotoxic effects reported for the AM1 metabolite. Our results do not implicate renal impairment in children born to post-transplant mothers, but one should note that none of the mothers chose to breastfeed their infants [35,36].…”

Section: Discussioncontrasting

confidence: 72%

Low Content of Cyclosporine A and Its Metabolites in the Colostrum of Post-Transplant Mothers

et al. 2020

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The rate of post-transplant mothers who breastfeed while on immunosuppression is progressively increasing. Data on breastfeeding while on cyclosporine-based regimens are limited. Therefore, we assessed the amount of cyclosporine and its metabolites that might be ingested by a breastfed infant by measuring the concentration of cyclosporine and its metabolites in the colostrum of seven post-transplant mothers. The mean concentration of cyclosporine in the colostrum was 22.40 ± 9.43 mcg/L, and the estimated mean daily dose of the drug was 1049.22 ± 397.41 ng/kg/24 h. Only three metabolites (AM1, DHCsA, and THCsA) had mean colostrum amounts comparable to or higher than cyclosporine itself, with the daily doses being 468.51 ± 80.37, 2757.79 ± 1926.11, and 1044.76 ± 948.56 ng/kg/24 h, respectively. Our results indicate a low transfer of cyclosporine and its metabolites into the colostrum in the first two days postpartum and confirm the emerging change to the policy on breastfeeding among post-transplant mothers. A full assessment of the safety of immunosuppressant exposure via breastmilk will require further studies with long-term follow-ups of breastfed children.

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Section: Discussioncontrasting

confidence: 72%

Low Content of Cyclosporine A and Its Metabolites in the Colostrum of Post-Transplant Mothers

et al. 2020

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“…Czaplinska et al assessed liver function (AST, ALT) and kidney function (creatinine and urea) in 51 infants born to mothers with a LiTx (newborns and children aged >1 year, age not specified). They did not find significant differences between the LiTx group and the control group matched to gestational age and time period of birth, except for significantly lower ALT levels in the LiTx group (60).…”

Section: Kidney Functionmentioning

confidence: 86%

“…Eight studies mentioned specific results on kidney function (12,13,26,32,33,(58)(59)(60). No abnormalities in kidney function were reported in 96% (243/252) of the assessed children.…”

Section: Kidney Functionmentioning

confidence: 99%

Follow-Up of Offspring Born to Parents With a Solid Organ Transplantation: A Systematic Review

Meinderts¹,

Prins²,

Berger³

et al. 2022

Transpl Int

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Pregnancy after solid organ transplantation (SOT) has potential risks for the offspring. Most existing research focused on short-term pregnancy outcomes. The aim of this systematic review was to evaluate available data concerning longer term outcomes (>1 year) of these children. A systematic literature search, following PRISMA guidelines, of PubMed and Embase was performed from the earliest date of inception through to 6th April 2022. Publications on all types of (combined) SOT were eligible for inclusion. In total, 53 articles were included. The majority assessed offspring after kidney (78% of offspring) or liver transplantation (17% of offspring). 33 studies included offspring aged >4 years and five offspring aged >18 years. One study was included on fathers with SOT. The majority of the 1,664 included children after maternal SOT had normal intellectual, psychomotor, and behavioral development. Although prematurity and low birth weight were commonly present, regular growth after 1 year of age was described. No studies reported opportunistic or chronic infections or abnormal response to vaccinations. In general, pregnancy after SOT appears to have reassuring longer term outcomes for the offspring. However, existing information is predominantly limited to studies with young children. Longer prospective studies with follow-up into adulthood of these children are warranted.

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“…The immunosuppressive agents most commonly used by patients after organ transplantation are tacrolimus, cyclosporine, azathioprine, glucocorticoids, mycophenolate mofetil, everolimus, and sirolimus. The main drugs used in the treatment regimens are calcineurin inhibitors: tacrolimus or cyclosporine [ 2 ]. Most of these drugs have been classified as Category C according to the FDA (Food and Drug Administration).…”

Section: Introductionmentioning

confidence: 99%

“…Most of these drugs have been classified as Category C according to the FDA (Food and Drug Administration). These drugs pass through the placenta and can have a negative effect on the fetus, including lymphatic system damage, but the literature on this problem is still scarce [ 2 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Immunological Status of Children Born to Female Liver Recipients

et al. 2018

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BackgroundImmunosuppressive treatment in pregnant organ recipients can affect functions of the fetal and newborn immune system. The aim of this study was to evaluate the effect of this treatment on selected parameters of the immune system of children born to mothers after liver transplantation.Material/MethodsThe study included 52 children born to liver recipients and 52 children in the control group. The study was conducted in the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw. Children from the 1st day of life to 10 years of age were examined. Serum antibody concentrations of IgG, IgM, and IgA were measured by the immune agglutination method on a Cobas 6000 analyzer.ResultsComparison of mean IgG, IgM, and IgA levels and with reference values did not show a significant difference between the study and control group (p>0.05). Immunoglobulin concentrations were also analyzed in the groups of children according to their age at the time of the test and the type of calcineurin inhibitor used in the mother’s treatment. The analysis showed a significant difference in the distribution of IgA concentrations in comparison to the normal values (p<0.05), as well as mean IgA (p<0.05) and IgM concentrations (p<0.05) according to the type of immunosuppressive treatment of the mother (tacrolimus or cyclosporin treatment regimen).ConclusionsAnalysis of the type of immunosuppressive therapy used during pregnancy revealed a possible influence of the type of calcineurin inhibitor on selected parameters of the immune system of the children; however, further research is needed to confirm these findings.

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Analysis of the Selected Biochemical Parameters of Liver and Kidney Function in Children of Mothers After Liver Transplantation

Cited by 5 publications

References 7 publications

Low Content of Cyclosporine A and Its Metabolites in the Colostrum of Post-Transplant Mothers

Low Content of Cyclosporine A and Its Metabolites in the Colostrum of Post-Transplant Mothers

Follow-Up of Offspring Born to Parents With a Solid Organ Transplantation: A Systematic Review

Immunological Status of Children Born to Female Liver Recipients

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