Cyclosporine and Its Metabolites in Mother and Baby

Abstract

Cyclosporine (CsA) is a potent immunosuppressive agent that has significantly improved allograft survival in recipients of human organ transplants (1,2). Recently there have been a few cases of successful pregnancies in transplant patients receiving CsA alone or in combination with steroids (3,4). A general concern regarding pregnancy in transplant patients is the potential harmful effect of chronic maternal immunosuppression on the fetus. It is essential to determine the extent of exposure of the fetus to the immunosuppressive drug and its metabolites. We recently studied the concentrations of CsA and several of its metabolites in maternal and cord blood, placenta, and the umbilical cord in two patients receiving chronic CsA therapy.

Protective Role of Polyphenols in Cyclosporine A-induced Nephrotoxicity During Rat Pregnancy

“…Negative effects such as prominent glomerular urinary chambers, tubular swelling, interstitial fibrosis, and inflammation are the same characteristics observed in rat kidney exposed to drug treatment (Rezzani 2004). Therefore, these findings showed the ability of CsA to cross the placenta and the importance of controlling the drug level and its metabolites as previously reported by several authors (Nyberg et al 1998;Venkataramanan et al 1988). These data agree with our report and other previous reports indicating that this drug and its metabolites interfere with fetal development (Bermas and Hill 1995;Sgro et al 2002;Tendron-Franzin et al 2004).…”

Reproduction After Transplantation

“…cyclosporine has been shown to cross the placenta (11), and levels have been reported in the newborns born to mothers on CyA. Our report documents the use of this immunosuppressive agent in 18 patients who received liver transplantation without any significant adverse sequelae.…”

Pregnancy After Liver Transplantation Under Tacrolimus1

“…Tacrolimus given to the mother is transmitted in significant amounts to the fetus despite its concentration in the placenta, similar to cyclosporine (16)(17)(18). Temporary impairment of the infants' renal function may be caused by tacrolimus, as has been previously reported with cyclosporine (19,20).…”