Pregnancy after renal transplantation: severe intrauterine growth retardation during treatment with cyclosporin A

Pickrell, M D; Sawers, R. S.; J, Michael

doi:10.1136/bmj.296.6625.825

Cited by 120 publications

(38 citation statements)

References 3 publications

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“…Compared to normal pregnancies, an increased risk of intrauterine growth retardation, low birth weight, and prematurity have been suggested in pregnant NTX patients [9]. This is in accordance with the data reported in four cases of pregnancies after IVF in NTX patients in the literature.…”

Section: Discussionsupporting

confidence: 90%

Live birth after in vitro fertilization and single embryo transfer in a kidney transplant patient: a case report and review of the literature

Nouri

Bader

Helmy

et al. 2010

J Assist Reprod Genet

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Background To present a successful case of in vitro fertilization (IVF) and single embryo transfer (SET) in a kidney transplant (NTX) patient and review of the literature. Methods Case report and review of the literature. Setting IVF-Unit in a university medical center. Patient(s) A 31 year-old nulliparous woman with primary infertility and a history of two kidney transplants. Intervention(s) IVF-SET Main outcome measure(s) Live birth, renal transplant function. Results(s) IVF-SET resulted in a pregnancy with labor induction and cesarean delivery in the 37th week of gestation due to rising serum creatinine. There was no significant maternal or fetal morbidity.Conclusion(s) Successful IVF-SET is possible in NTX patients. To date, including this case, five cases of IVF in NTX patients have been reported in the literature without an apparently increased renal morbidity.

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Section: Discussionsupporting

confidence: 90%

Live birth after in vitro fertilization and single embryo transfer in a kidney transplant patient: a case report and review of the literature

Nouri

Bader

Helmy

et al. 2010

J Assist Reprod Genet

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“…It (117,118,127,128), and prednisolone (118,129,130). Limited amounts of CsA or AZA cross the placenta; however, observations of transient neonatal thrombocytopenia, leukopenia, and hypoplasia of the lymphatic system in children exposed to CsA (124) or to AZA and prednisolone (131,132) during pregnancy suggest that some developmental immunotoxicity results from maternal exposure to these agents. The long-term immune consequences (e.g., postpuberty) from such exposure in these children remains unknown.…”

Section: Development Of the Immune Systemmentioning

confidence: 92%

Development of the murine and human immune system: differential effects of immunotoxicants depend on time of exposure.

Holladay

Smialowicz

2000

Environ Health Perspect

238

177

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Fetal and early postnatal life represent critical periods in vertebrate immune system development. Disruption of such development by perinatal immunotoxic chemical exposure has been widely described in experimental animal models. The resultant inhibited postnatal immune responses in such animals are often more dramatic and persistent than those after exposure during adult life. Further, recent reports suggest that prenatal exposure to immunotoxicants may exacerbate postnatal aberrant immune responses (e.g., hypersensitivity disorders and autoimmune disease) in genetically predisposed rodents. Limited information is available regarding the possibility of inhibited postnatal immune capacity in humans as a result of developmental immunotoxicant exposure. The multifactorial nature of hypersensitivity and autoimmune responses will further complicate the elucidation of possible relationships between chemical exposure during ontogeny of the human immune system and immune-mediated disease later in life. Taken together, however, the available animal data suggest the potential for altered postnatal immune function in humans exposed to immunotoxicants (e.g., environmental chemicals and therapeutic agents) during fetal and/or early postnatal life.

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“…Therapeutic concentrations of cyclosporin A in blood are in the range of 0.1-0.6 pM (14), but occurrence of higher concentrations is not uncommon (3,15). Figure 1 describes the doseresponse relationship for the inhibitory effect of cyclosporin A on taurine transport in human placental choriocarcinoma cells.…”

Section: Resultsmentioning

confidence: 99%

“…In comparison with much investigated toxic effects such as nephrotoxicity, hepatotoxicity, and hypertension, much less is known about the influence of cyclosporin A treatment on pregnancy. There are two reports currently available that review the course and outcome of pregnancy in patients receiving cyclosporin A (3,4). A striking observation in both reports is an increased occurrence of intrauterine growth retardation during treatment with the drug.…”

mentioning

confidence: 99%

Selective Impairment of Taurine Transport by Cyclosporin A in a Human Placental Cell Line

et al. 1992

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ABSTRACT. We investigated, using a human placental choriocarcinoma cell line as a model, the effects of the immunosuppressive drug cyclosporin A on several placental transport systems mediating the transfer of glucose and amino acids from mother to fetus. The results of the investigation show that the transport system responsible for the transfer of taorine is selectively impaired by the drug, whereas the other transport systems are either stimulated or not affected. The inhibitory effect of the drug on taurine transport appears to be due to interference with calmodulin-dependent processes because calmodulin antagonists such as W-7, calmidazolium, and CGS 9343B mimic the effects of cyclosporin A. FK506, another immunosuppressive drug that is currently undergoing clinical trials, does not have this inhibitory effect. (Pediatr Res 32: 125-127,1992)

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Pregnancy after renal transplantation: severe intrauterine growth retardation during treatment with cyclosporin A

Cited by 120 publications

References 3 publications

Live birth after in vitro fertilization and single embryo transfer in a kidney transplant patient: a case report and review of the literature

Live birth after in vitro fertilization and single embryo transfer in a kidney transplant patient: a case report and review of the literature

Development of the murine and human immune system: differential effects of immunotoxicants depend on time of exposure.

Selective Impairment of Taurine Transport by Cyclosporin A in a Human Placental Cell Line

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