Document Detail


Gynecological issues after organ transplantation.
MedLine Citation:
PMID:  19112398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Organ transplantation has become universally accepted treatment of end-stage organ failure. The main problem focuses on preventing the graft from rejection with the use of immunosuppressive agents. High incidence of infection is the most frequent adverse effect of immunosuppressive therapy. Symptoms of inflammation are often reduced in immunosuppressed patients. All invasive diagnostic and therapeutic procedures should be associated with the increase in dose of steroids and prophylactic antibiotics. Ovarian and menstrual function is usually restored in transplanted women. Function of the hypothalamus-pituitary-ovary axis in transplanted women is believed to be normal. Most common abnormal uterine bleeding in graft recipient are: prolonged and profuse menstruation and inter-menstrual bleeding or spotting. Among the underlying diseases are lesions of the uterus (fibroids, endometrial or cervical polyps), infections of sex organs or hormonal disturbances. Higher rate of endometrial hyperplasia (without atypia) is reported in renal graft recipients. Organ transplantation results in the restored fertility thus effective family planning method is necessary in women of reproductive age who do not want to conceive. Vaginal diaphragms are not advised and intrauterine device are contradicted. Observational studies indicate for safety and high rate of acceptance of oral and transdermal hormonal contraception in transplanted women. Over ten-year experiences of HRT administration in graft recipient have proved the benefits of the therapy. Patients after organ transplantation have three to four-fold increased incidence of malignancy compared with general population. All transplant women must undergo regular gynecological screening for premalignant and malignant lesions of sex organs and breast.
Authors:
Pawel Kaminski; Katarzyna Bobrowska; Bronislawa Pietrzak; Leszek Bablok; Miroslaw Wielgos
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Neuro endocrinology letters     Volume:  29     ISSN:  0172-780X     ISO Abbreviation:  Neuro Endocrinol. Lett.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8008373     Medline TA:  Neuro Endocrinol Lett     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  852-6     Citation Subset:  IM    
Affiliation:
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
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MeSH Terms
Descriptor/Qualifier:
Contraception / methods*
Endometrial Hyperplasia / etiology,  immunology
Female
Genital Diseases, Female / etiology*,  immunology
Genital Neoplasms, Female / immunology,  therapy*
Humans
Immunosuppression
Immunosuppressive Agents / adverse effects*
Menstruation Disturbances / chemically induced,  immunology
Organ Transplantation / adverse effects*,  physiology
Transplantation Immunology / physiology
Uterine Diseases / etiology,  immunology
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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