Immunophenotypic Profile and Increased Risk of Hospital Admission for Infection in Infants Born to Female Kidney Transplant Recipients

Safe administration of rotavirus vaccine in a cohort of infants exposed to immunosuppressive drugs during gestation

“…Our group has previously described immune alterations at birth in this cohort of infants born to renal transplanted mothers exposed to immunosuppressive drugs during gestation. They have low numbers of B lymphocytes, and also low CD4+ T lymphocytes and NKT cells . Nevertheless, normal lymphocyte subset numbers are attained in the majority of infants after a few months and they show appropriate humoral immune response to vaccination administered in the first 6 months, with no differences in antibody levels to tetanus, Haemophilus influenzae type b, and 7 pneumococcus serotypes when compared to healthy infants .…”

“…In the present study, 3 infants were hospitalized during this period after rotavirus vaccine, but these events were not associated with the vaccine. Higher rates of hospitalization for serious infections in the first 2 months are observed in children born to transplanted mothers, probably because of immune alterations at birth …”

“…Infants born to renal transplanted mothers exposed to immunosuppressive drugs during pregnancy show clear immune alterations at birth and a higher risk of hospital admission for infection in the first months of life …”

Pharmacologic Considerations for Solid Organ Transplant Recipients Who Become Pregnant

“…Whether this impaired immunity translates to poor long‐term clinical outcomes remains to be answered. When matched to children born to non–transplant recipients according to sex, gestational age, and birth weight, infants born to female kidney transplant recipients were more likely to be hospitalized for infections within the first year of life . In addition, this impaired immune response may also negatively affect an infant's responses to routine vaccinations.…”

“…When matched to children born to non-transplant recipients according to sex, gestational age, and birth weight, infants born to female kidney transplant recipients were more likely to be hospitalized for infections within the first year of life. 22 In addition, this impaired immune response may also negatively affect an infant's responses to routine vaccinations. A study 23 reported suboptimal response to tetanus toxoid in 5 of 28 infants born to mothers with autoimmune disorders who were receiving immunosuppressive agents throughout their pregnancies, including cyclosporine and corticosteroids.…”