| Teratogenesis and immunosuppressive treatment. | |
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MedLine Citation:
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PMID: 15110638 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Despite the potential risks to the mother and fetus caused by immunosuppressive drugs, uneventful pregnancies are now frequent among transplant recipients. Although there is no apparent increase in the type or incidence of malformations in the newborns or evidence of graft dysfunction, pregnancy-related complications, including premature termination and low birth weight, may be more frequent. To prevent graft rejection due to the increased immunologic reactivity of the transplant recipient during pregnancy, it is reasonable to wait 2 years after transplantation before conception, to have stable graft function and to be on low drug doses for maintenance immunosuppression. Among the immunosuppressive agents, corticosteroids may induce a number of treatment-related complications, including diabetes and osteoporosis; however, the incidence of fetal malformations during corticosteroid treatment is about 3.5%, a value close to that of the general population. Among immunosuppressive antibodies, no evidence of developmental toxicity has been demonstrated with basiliximab. On the contrary, some concerns have been raised about azathioprine, since its use has been associated with fetal abnormalities in animals; however, clinical data so far have indicated only a small teratogenic risk. Therefore, immunosuppressive therapy with selected drugs and antibodies does not apparently increase the risk of birth defects and may be continued in pregnancy. Finally, although breast-feeding is not recommended, because of drug transfer into maternal milk, the available clinical data do not support this limitation because of the low amount of drug absorbed by the infant and the absence of clinical toxicity in published case reports. |
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Authors:
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R Danesi; M Del Tacca |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Transplantation proceedings Volume: 36 ISSN: 0041-1345 ISO Abbreviation: Transplant. Proc. Publication Date: 2004 Apr |
Date Detail:
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Created Date: 2004-04-27 Completed Date: 2004-11-16 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0243532 Medline TA: Transplant Proc Country: United States |
Other Details:
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Languages: eng Pagination: 705-7 Citation Subset: IM |
Affiliation:
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Division of Pharmacology and Chemotherapy, Department of Oncology, Transplants, and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy. r.danesi@med.unipi.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abnormalities, Drug-Induced* Cyclosporine / toxicity Female Humans Immunosuppressive Agents / adverse effects* Pregnancy Prenatal Exposure Delayed Effects Safety Teratogens* United States United States Food and Drug Administration |
| Chemical | |
Reg. No./Substance:
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0/Immunosuppressive Agents; 0/Teratogens; 59865-13-3/Cyclosporine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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