Kidney transplantation and pregnancy

Zachariah, Mareena; Tornatore, Kathleen M.; Venuto, Rocco C.

doi:10.1097/mot.0b013e32832dbc34

Cited by 28 publications

(20 citation statements)

References 44 publications

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“…Transplantation Pregnancy Registry the prevalence of major structural malformations in the offspring of mothers exposed to CsA was 4-5%. This is comparable to the prevalence in the general population (3-5%) [21].…”

Section: Discussionsupporting

confidence: 63%

Administration of Cyclosporine A in Pregnant Rats - the Effect on Blood Pressure and on the Glomerular Number in Their Offspring

Słabiak-Błaż¹,

Adamczak²,

Gut³

et al. 2015

Kidney Blood Press Res

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Background/Aims: Cyclosporine A (CsA) is a commonly used immunosuppressive agent. In some patients treatment with CsA has to be continued during pregnancy. The aim of the study was to assess in an experimental model whether the exposure to CsA during fetal life influences the number and volume of glomeruli, kidney function and blood pressure in the offspring. Methods: Eight pregnant female Sprague-Dawley rats were allocated to 2 treatment regimens: with CsA or solvent. Blood pressure was measured in the offspring at 7 and 11 weeks of age and albuminuria was determined at 11 weeks of age. In the kidney the number and mean volume of glomeruli was assessed using stereological methods. Results: In the offspring of pregnant rats treated with CsA the number of glomeruli was significantly lower and the mean volume of glomeruli was higher when compared to the offspring of pregnant rats receiving solvent. Systolic and diastolic blood pressures as well as albuminuria were significantly higher in the offspring of mothers treated with CsA during gestation compared to the offspring from the control group. Conclusions: Exposure of rats to CsA during fetal life impairs kidney development, thus potentially predisposing to chronic kidney disease and hypertension in the adult life.

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Section: Discussionsupporting

confidence: 63%

Administration of Cyclosporine A in Pregnant Rats - the Effect on Blood Pressure and on the Glomerular Number in Their Offspring

Słabiak-Błaż¹,

Adamczak²,

Gut³

et al. 2015

Kidney Blood Press Res

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“…However, the most common immunosuppressive regimen has been a triple regimen with combinations of corticosteroids, calcineurin inhibitors (cyclosporine A or tacrolimus) and azathioprine or mycophenolate mofetil in this and most transplantation programs worldwide throughout the study period (5,(29)(30)(31)(32). A causal link between a specific immunosuppressive drug and preeclampsia is thus difficult to establish based solely on these findings.…”

Section: Pregnancies Fathered By Transplanted Malesmentioning

confidence: 99%

Obstetric and Neonatal Outcome of Pregnancies Fathered by Males on Immunosuppression After Solid Organ Transplantation

Morken

Díaz-García

Reisæter

et al. 2015

American Journal of Transplantation

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Immunosuppressive drugs may influence spermatogenesis, but little is known about outcome of pregnancies fathered by transplanted males. We estimated risk of adverse outcomes in pregnancies (with data after the first trimester) fathered by males that had undergone organ transplantation and were treated with immunosuppression. A population-based study, linking data from the Norwegian transplant registry and the Medical Birth Registry of Norway during 1967-2009 was designed. All Norwegian men undergoing solid organ transplantation were included. Odds ratios for major malformations, preeclampsia, preterm delivery (<37 weeks) and small-for-gestational-age were obtained using logistic regression. A total of 2463 transplanted males, fathering babies of 4614 deliveries before and 474 deliveries after transplantation were identified. The risk of preeclampsia was increased (AOR: 7.4, 95% CI: 1.1-51.4,) after transplantation compared to prior to transplantation. No increased risk was found for congenital malformations or other outcomes when compared with pregnancies before transplantation or with the general population (2 511 506 births). Our results indicate an increased risk of preeclampsia mediated through the transplanted and immunosuppressed father. Importantly, no increased risk was found for other adverse obstetric outcomes or malformations, which may reassure male transplant recipients planning to father children.

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“…[10] Birçok immünsüpresif ajan gebelik kategorisi C olarak belirtilmekte iken azotiyopirin D kategorisindedir. [1,11] Bununla birlikte azotiyopirinin yüksek dozları ile hayvanlarda teratojenik etkiler görülmekte iken renal transplantlı hastaların fetuslarında düşük doğum ağırlığı, prematurite, sarılık, respiratuvar distres sendromu ve aspirasyon belirtilmiştir. [12] Mikofenalat mofetil ise fetal kayıp ve yüksek doğumsal anomali riski nedeniyle kategori C grubundan D grubuna alınmıştır ve gebelikte kullanımı önerilmemektedir.…”

Section: Kaynaklarunclassified

“…[12] Mikofenalat mofetil ise fetal kayıp ve yüksek doğumsal anomali riski nedeniyle kategori C grubundan D grubuna alınmıştır ve gebelikte kullanımı önerilmemektedir. [11] Yapılan bir çalışmada mikofenalat mofetil kullanan renal transplantlı hastalarda spontan abortuslarla birlikte canlı doğumlarda hipoplastik tırnak, kısa 5. parmak, yarık damak ve dudak ile birlikte mikrotia içeren malformasyonlar gözlenmiştir. [13] Gebelik isteği olan transplant hastalarında siklosporin ve takrolimus, kortikosteroid ve azotioprin ile birlikte veya tek başlarına gebelikte devam edilebileceği belirtilirken, mikofenalat gibi fetal anomali riski olan ajanlar öne-rilmemektedir.…”

Section: Kaynaklarunclassified