Open AccessJournal Article
Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation.
Lisa A. Coscia,Serban Constantinescu,Michael J. Moritz,Adam M. Frank,Carlo B. Ramirez,Warren R. Maley,Cataldo Doria,Carolyn H. McGrory,Vincent T. Armenti +8 more
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TLDR
Key benefits of the NTPR are the personal contact between registry staff and participants, the wide range of pregnancy-related variables that are analyzed, and the opportunity for health-care providers to obtain information that helps them care for transplant recipients on a case-by-case basis.Abstract:
The NTPR continues to maintain an ongoing active database as a resource for health professionals counseling recipients regarding pregnancy and for recipients themselves to contact the registry and request information. This includes female transplant recipients as well as male recipients who father pregnancies. Recipients who consent are entered into a database; analyses are ongoing, including long-term follow-up of the recipient, the graft and the offspring. The safety of pregnancy for parent and child remains the goal of the registry. Guidelines for counseling recipients proposed in 1976 remain applicable. Recipients should be in general good health and graft function should be stable and ideally rejection free. Comorbid conditions should be well controlled, especially hypertension and diabetes. While these counseling guidelines were formulated for kidney recipients, they may be extrapolated for other organ recipients. Analyses this year included pregnancy outcomes of recipients on newer agents, MMF and sirolimus. It remains unclear whether these adjunctive therapies should be altered for pregnancy. The balance of immunosuppression and the prevention of rejection need to be weighed against the potential for teratogenicity when counseling these recipients inquiring about pregnancy. Although there are periodic reports of recipients with graft dysfunction, rejection or graft loss possibly related to pregnancy events throughout all the organ groups, whether transplanted as adults or as pediatric patients, the majority of pregnancy outcomes reported to the NTPR appear favorable for parent and newborn. Whether recipients should breastfeed remains controversial. Recent reports in the literature as well as NTPR data appear favorable. This represents the last report from our initial established location at Thomas Jefferson University. In January of this year, the registry moved to Temple University School of Medicine, Department of Surgery, Philadelphia, PA. The NTPR remains committed to investigating outcomes of pregnancies reported by centers or self-referrals nationwide. Some of the active issues for the upcoming year include the potential for teratogenicity with combinations of newer agents, incidence of viral hepatitis, risk assessment for pregnancy in female lung recipients, and long-term maternal and pediatric follow-up.read more
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The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients
Maria Rosa Costanzo,Anne I. Dipchand,Randall C. Starling,Allen S. Anderson,Michael Chan,Shashank Desai,Savitri Fedson,Patrick W. Fisher,Gonzalo Gonzales-Stawinski,Luigi Martinelli,David C. McGiffin,Jon Smith,David O. Taylor,Bruno Meiser,Steven A. Webber,David A. Baran,Michael P. Carboni,Thomas J. Dengler,David L. Feldman,Maria Frigerio,Abdallah G. Kfoury,Daniel Kim,Jon A. Kobashigawa,Michael A. Shullo,Josef Stehlik,Jeffrey J. Teuteberg,Patricia A. Uber,Andreas Zuckermann,Sharon A. Hunt,Michael Burch,Geetha Bhat,Charles E. Canter,Richard E. Chinnock,Marisa G. Crespo-Leiro,Reynolds M. Delgado,Fabienne Dobbels,Kathleen L. Grady,W. Kao,Jaqueline Lamour,Gareth Parry,Jignesh Patel,Daniela Pini,Jeffrey A. Towbin,Gene Wolfel,Diego H. Delgado,Howard J. Eisen,Lee R. Goldberg,Jeff Hosenpud,Maryl R. Johnson,Anne Keogh,Clive Lewis,John B. O'Connell,Joseph G. Rogers,Heather J. Ross,Stuart D. Russell,Johan Vanhaecke,Amanda W. Rowe +56 more
TL;DR: Institutional Affiliations Chair Costanzo MR: Midwest Heart Foundation, Lombard Illinois, USA Task Force 1 Dipchand A: Hospital for Sick Children, Toronto Ontario, Canada; Starling R: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Starlings R: University of Chicago, Chicago, Illinois,USA; Chan M: university of Alberta, Edmonton, Alberta, Canada ; Desai S: Inova Fairfax Hospital, Fairfax, Virginia, USA.
Journal ArticleDOI
Anti-inflammatory and immunosuppressive drugs and reproduction.
Monika Østensen,Munther A. Khamashta,Michael D. Lockshin,Ann L. Parke,Antonio Brucato,Howard Carp,Andrea Doria,Raj Rai,Pier Luigi Meroni,Irene Cetin,Ronald H. W. M. Derksen,Ware Branch,Mario Motta,Caroline Gordon,Guillermo Ruiz-Irastorza,Arsenio Spinillo,Deborah I. Friedman,Rolando Cimaz,Andrew Czeizel,J.C. Piette,Ricard Cervera,Roger A. Levy,Maurizio Clementi,Sara De Carolis,Michelle Petri,Yehuda Shoenfeld,D Faden,Guido Valesini,Angela Tincani +28 more
TL;DR: Benefits of anti-inflammatory, immunosuppressive and biological drugs during pregnancy and lactation, effects of these drugs on male and female fertility and possible long-term effects on infants exposed to drugs antenatally are discussed.
Journal ArticleDOI
Long‐term management of the successful adult liver transplant: 2012 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation
Michael R. Lucey,Norah A. Terrault,Lolu Ojo,J. Eileen Hay,James Neuberger,Emily A. Blumberg,Lewis W. Teperman +6 more
TL;DR: This research presents a novel and scalable approach to regenerative medicine that combines traditional and innovative approaches to Gastroenterology and Hepatology that have shown real-world applications in the treatment of central giant cell granuloma.
Journal ArticleDOI
Pregnancy outcome after cyclosporine therapy during pregnancy: a meta-analysis.
TL;DR: CsA does not appear to be a major human teratogen and may be associated with increased rates of prematurity, although more research is needed to evaluate whether cyclosporine increases teratogenic risk.
Journal ArticleDOI
Reproduction and Transplantation: Report on the AST Consensus Conference on Reproductive Issues and Transplantation
TL;DR: This study highlights the need to understand more fully the pre- and post-transplant role of immune suppression in the selection and timing ofitoneal organ transplants.
References
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Journal ArticleDOI
Successful Pregnancies after Human Renal Transplantation
TL;DR: Extra-corporeal hemodialyses were required on three occasions to sustain life until the necessary preliminary studies were completed in one of a pair of twenty-one-year-old identical twin females from Oklahoma.
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Mycophenolate mofetil in pregnancy after renal transplantation: a case of major fetal malformations.
TL;DR: This case of fetal malformation attributable to mycophenolate mofetil must be taken into consideration when considering pregnancy in an organ-transplant recipient.
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Kidney transplantation during the first trimester of pregnancy: immunosuppression with mycophenolate mofetil, tacrolimus, and prednisone.
TL;DR: It is reassuring to know that a successful outcome can be expected in mothers treated with MMF during pregnancy, after a case of living, related-donor kidney transplantation during the first trimester of pregnancy.
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Planned pregnancy in a renal transplant recipient
TL;DR: The patient showed the physiological changes in homeostasis of normal pregnancy and the patient was delivered of a live male child and the neonatal problems are described.