The Presence of Cyclosporine in Body Tissues and Fluids During Pregnancy

Flechner, Stuart M.; Katz, Ariel; ROGERS, A.J.; Buren, C. Van; Kahan, Barry D.

doi:10.1016/s0272-6386(85)80138-4

Cited by 150 publications

(60 citation statements)

References 7 publications

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“…Cyclosporine was present at delivery in maternal and cord blood (86 and 54 ng/mL, respectively) and was found in breast milk obtained on days 2, 3, and 4 (101, 109, and 263 ng/mL, respectively). 56,57 Flechner et al 58 reported cyclosporine levels using a radioimmunoassay from a 36-year-old kidney transplant recipient who delivered at 38 weeks. Levels were measured along with the number of hours from the previous cyclosporine dose; the maternal blood trough level was 155 ng/mL at 12 hours.…”

Section: Discussionmentioning

confidence: 99%

“…For some investigators, including transplant physicians 58 and lactation experts, 65,66 any exposure exceeds their threshold for safety, and they believe a woman administered immunosuppressive therapy should not breast-feed. For others, the lack of long-term effects of the relatively high in utero exposure and the very low level of infant drug exposure, together with the documented benefits to the infant of breastfeeding, more than outweigh the theoretical concerns of undiscovered risk.…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy after liver transplantation

et al. 2000

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The first known posttransplantation pregnancy was in 1958 in a renal transplant recipient who had received a kidney from her identical twin sister. The first known posttransplantation pregnancy in a liver transplant recipient was in 1978. Information available from female kidney transplant recipients helped in the decision making involved in the management of this case, as well as those that followed. Over the last 20 years, issues specific to liver transplantation and pregnancy have been identified. Similar to the kidney transplant recipient population, when prepregnancy recipient graft function is stable and adequate, pregnancy appears to be well tolerated. Also similar to kidney transplant recipients, there has been no evidence of a specific malformation pattern among the children, and although prematurity and low birth weight occur, overall newborn outcomes have been favorable. Pregnancy in the setting of recurrent liver disease, such as recurrent hepatitis C, poses a potential problem among liver transplant recipients, as well as the possible adverse effects of immunosuppression on maternal kidney function. Also of significance, peripartum graft deterioration has more severe consequences in this transplant recipient population. Therefore, pregnancy must be considered carefully in this transplant recipient group. Since 1991, the National Transplantation Pregnancy Registry (NTPR) has studied the safety of pregnancy outcomes in solid-organ transplant recipients. The purpose of this review is to catalog studies in the literature, as well as to present current data from the registry with management guidelines. (Liver Transpl 2000;6:671-685.)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pregnancy after liver transplantation

et al. 2000

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“…CNI readily cross the placenta and enter the fetal circulation. In fact, in one study, it was found that cyclosporine in fetal blood was able to inhibit T cell function to the same degree as that found in maternal serum (87). Much less is known about the maternal-fetal transport of MMF and sirolimus.…”

Section: Risks Of Pregnancy To the Fetusmentioning

confidence: 99%

Pregnancy after Kidney Transplantation

McKay

Josephson²

2008

Clinical Journal of the American Society of Nephrology

127

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Reproductive success is a common, expected outcome for male and female recipients of solid-organ transplants. Men can father children, and women can become pregnant and carry the fetus to delivery. There are, however, important maternal and fetal complications that need to be considered to provide optimal care to the mother and her infant. Although pregnancy is common after the transplantation of all solid organs, guidelines for optimal counseling and clinical management are limited. This review discusses information to help the physician counsel the kidney transplant recipient about risks of pregnancy for the mother and the fetus and provides information to help guide treatment of the pregnant transplant recipient.

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“…This moiety does pass into the fetus and a relative fetal lack of the enzyme inosine pyrophosphorylase prevents it from being transformed into its active form thioinosinic acid (72). CNI readily cross the placenta and enter the fetal circulation (1,73). In one study, it was found that cyclosporine in fetal blood was able to inhibit T cell function to the same degree as that found in maternal serum (73).…”

Section: Pregnancymentioning

confidence: 99%

“…CNI readily cross the placenta and enter the fetal circulation (1,73). In one study, it was found that cyclosporine in fetal blood was able to inhibit T cell function to the same degree as that found in maternal serum (73). Much less is known about the maternal-fetal transport of MMF and sirolimus.…”

Section: Pregnancymentioning

confidence: 99%