Autoimmune and pregnancy complications in the daughter of a kidney transplant patient

Transplantation
James R ScottJohn Holman

Abstract

Immunosuppressive agents taken by pregnant organ transplant recipients readily cross the placenta during development of the fetal immune system. There are few data on the long-term implications for the progeny, but evidence from animal studies suggest that second and third generations of organ transplant patients may be at risk for autoimmune disorders and reproductive problems. We present the 23-year-old daughter of a renal allograft recipient exposed to azathioprine 75 mg/day and prednisone 5 mg/day throughout her mother's pregnancy. During the daughter's first pregnancy, she developed multiple autoantibodies, Raynaud's phenomenon, and fetal death occurred at 20 weeks gestation. The second pregnancy was complicated by systemic lupus erythematosus, preeclampsia, and the birth of a preterm male infant. It is uncertain whether the autoimmune manifestations and obstetric complications in this patient were related to fetal exposure to immunosuppressive drugs. Nevertheless, further studies on the health and pregnancies of adult offspring of transplant patients are warranted.

References

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Citations

May 23, 2006·Arthritis Research & Therapy·Monika ØstensenAngela Tincani
Mar 20, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Dianne B McKay, Michelle A Josephson
Aug 14, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Pia EgerupOle Bjarne Christiansen
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Nov 10, 2009·Human Reproduction Update·Mats BrännströmAlbert Altchek
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Apr 3, 2020·Autoimmunity Reviews·Cristina BeliznaLaura Andreoli

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