Pregnancy in renal transplantation: immunologic evaluation of neonates from mothers with transplanted kidney

Schena, Francesco Paolo; Stallone, Giovanni; Schena, Antonio; Manfredi, G; Derosa, Clorinda; Procino, A; Paolo, Salvatore Di

doi:10.1016/s0966-3274(02)00028-x

Cited by 26 publications

(20 citation statements)

References 12 publications

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“…Animal studies have shown that in utero exposure to calcineurin inhibitors causes hypoplastic peripheral lymphatic organs, immature T cells, and nonfunctional T cell reactivity [35]. In human neonates, cyclosporine may cause immature T cell and low number of B cells which may possibly lead to development of autoimmunity [36]. Developmental delays were found in 16% of children with mean age of 4.4 years who received cyclosporine in utero [37].…”

Section: Immunosuppressionmentioning

confidence: 99%

Overview of Pregnancy in Renal Transplant Patients

Shah

Verma

2016

International Journal of Nephrology

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Kidney transplantation offers best hope to women with end-stage renal disease who wish to become pregnant. Pregnancy in a kidney transplant recipient continues to remain challenging due to side effects of immunosuppressive medication, risk of deterioration of allograft function, risk of adverse maternal complications of preeclampsia and hypertension, and risk of adverse fetal outcomes of premature birth, low birth weight, and small for gestational age infants. The factors associated with poor pregnancy outcomes include presence of hypertension, serum creatinine greater than 1.4 mg/dL, and proteinuria. The recommended maintenance immunosuppression in pregnant women is calcineurin inhibitors (tacrolimus/cyclosporine), azathioprine, and low dose prednisone; and it is considered safe. Sirolimus and mycophenolate mofetil should be stopped 6 weeks prior to conception. The optimal time to conception continues to remain an area of contention. It is important that counseling for childbearing should start as early as prior to getting a kidney transplant and should be done at every clinic visit after transplant. Breast-feeding is not contraindicated and should not be discouraged. This review will help the physicians in medical optimization and counseling of renal transplant recipients of childbearing age.

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Section: Immunosuppressionmentioning

confidence: 99%

Overview of Pregnancy in Renal Transplant Patients

Shah

Verma

2016

International Journal of Nephrology

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“…In addition, low levels of serum immunoglobulins occur at the same time. This leads to suggest a delayed administration of classical vaccinations (after the first 6 months of life) in view of the potential risks of both sub-optimal immunologic responses, and adverse events after the administration of live, attenuated vaccines in infants born from young female organ transplant recipients (Schen 2002). An infant born to an HBSAg -positive mother should be given hepatitis B immunoglobulin within 12 hours of birth and HBV vaccine at another site within 48 hours followed by a booster injection at 1 and 6 month.…”

Section: Viralmentioning

confidence: 99%

Sexual and Reproductive Function in Chronic Kidney Disease and Effect of Kidney Transplantation

Lessan‐Pezeshki¹,

Ghazizadeh²

2011

After the Kidney Transplant - The Patients and Their Allograft

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“…Immunoglobulin levels normalized by around 4 months of age, but IgG1 and IgG3 levels remained lower compared to the control group at up to 6 months of age. Despite the absence of clinical signs of immune dysfunction, the authors suggested postponement of vaccination in these children up to 6 months of age [ 19 ].…”

Section: Discussionmentioning

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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Pregnancy in renal transplantation: immunologic evaluation of neonates from mothers with transplanted kidney

Cited by 26 publications

References 12 publications

Overview of Pregnancy in Renal Transplant Patients

Overview of Pregnancy in Renal Transplant Patients

Sexual and Reproductive Function in Chronic Kidney Disease and Effect of Kidney Transplantation

Immunological Status of Children Born to Female Liver Recipients

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