Benutzer: Gast  Login
Titel:

Effect of pregnancy on long-term kidney function in renal transplant recipients treated with cyclosporine and with azathioprine.

Dokumenttyp:
Journal Article; Article
Autor(en):
Fischer, T; Neumayer, HH; Fischer, R; Barenbrock, M; Schobel, HP; Lattrell, BC; Jacobs, VR; Paepke, S; von Steinburg, SP; Schmalfeldt, B; Schneider, KT; Budde, K
Abstract:
In order to investigate the effect of different immunosuppressive regimens and the time interval between transplantation and pregnancy on long-term outcome, we performed a case-control study in pregnant renal allograft recipients. Eighty-one pregnancies of kidney transplanted recipients were identified [cyclosporine (CYA): n = 40; azathioprine (AZA): n = 41]. Controls were matched with respect to important prognostic factors. Posttransplant follow-up was 91.3 +/- 5 months. Graft and patient survival were similar in both groups and there was no apparent effect of immunosuppression. A total of 28 recipients (33%) delivered within 2 years and 6 (8%) subjects within 1 year after transplantation, but these short transplantation-to-pregnancy intervals had no apparent adverse effect on long-term outcome. In contrast to AZA-treated patients, CYA-treated patients experienced an increase in serum creatinine postpartum (1.15 +/- 0.2 mg/dL vs. 1.61 +/- 0.1 mg/dL; p < 0.05). Whole blood CYA levels decreased transiently during pregnancy from 115.9 +/- 8 ng/mL to 80.7 +/- 7 ng/mL leading to a gradual increase in drug dose from 240 +/- 14 mg/day to 324 +/- 21 mg/day (p < 0.05). Following delivery, there was an increase in CYA concentrations to 173 +/- 5.4 ng/mL, requiring rapid dose tapering to baseline of 246 +/- 15 mg/day. Pregnancies in renal recipients do not affect long-term patient and graft survival, independent of the immunosuppression. No detrimental effect of short transplantation-to-pregnancy intervals on long-term graft function was detected.
Zeitschriftentitel:
Am J Transplant
Jahr:
2005
Band / Volume:
5
Heft / Issue:
11
Seitenangaben Beitrag:
2732-9
Sprache:
eng
Volltext / DOI:
doi:10.1111/j.1600-6143.2005.01091.x
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/16212634
Print-ISSN:
1600-6135
TUM Einrichtung:
Fachgebiet Perinatalmedizin und Perinatalphysiologie (Prof. Schneider); Frauenklinik und Poliklinik
 BibTeX