Immunosuppressant Therapy in Pregnant Organ Transplant Recipients

Transplant recipients are becoming pregnant with increasing frequency, and successful pregnancy outcomes have now been reported for women with all types of solid organ transplants. To prevent rejection of the transplanted organ, these patients are maintained on a life-long immunosuppressive regimen...

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Bibliographic Details
Published in:Seminars in perinatology 2007-12, Vol.31 (6), p.363-371
Main Authors: Fuchs, Karin M., MD, Coustan, Donald R., MD
Format: Article
Language:English
Subjects:
Female
Fetus - drug effects
Graft Rejection - epidemiology
Graft Rejection - prevention & control
Humans
immunosuppressant
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Neonatal and Perinatal Medicine
Pregnancy
Pregnancy Outcome
Pregnancy, High-Risk
Prenatal Exposure Delayed Effects
Safety
teratogen
transplant
Transplantation Immunology
Transplants
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Summary:Transplant recipients are becoming pregnant with increasing frequency, and successful pregnancy outcomes have now been reported for women with all types of solid organ transplants. To prevent rejection of the transplanted organ, these patients are maintained on a life-long immunosuppressive regimen that must also be continued through pregnancy. Controlled human studies of the safety of these drugs have not been conducted, and knowledge regarding the pharmacokinetics of these medications in pregnancy is limited. Significant experience and safety data regarding the use of some of the more common immunosuppressants in pregnancy have, however, been accumulated from large case series and national registries. These observational studies suggest that successful pregnancy outcomes are possible in female organ transplant recipients, although sporadic adverse outcomes have been reported after immunosuppressant use in pregnancy. In this chapter, we will outline the information available regarding the use of immunosuppressive medications in pregnant transplant recipients as well as general concepts regarding fetal exposure to immunosuppressants.
ISSN:0146-0005
1558-075X
DOI:10.1053/j.semperi.2007.09.006