title: Successful outcome of a complicated pregnancy in a renal transplant recipient taking cyclosporine A.
abstract: The successful outcome of a pregnancy complicated by reversible renal failure secondary to total ureteral obstruction caused by a pregnant uterus and treated temporarily with nephrostomy is reported. The cyclosporine A (CsA) and prednisone treated female recipient of a cadaveric renal allograft gave birth to a male child, which at 2080 grams was small for gestational age (35 weeks of pregnancy). The child presented neither signs of congenital anomalies or chromosome aberrations nor nephrotoxicity, hepatotoxicity or anemia. Simultaneous measurement of trough CsA blood levels (CsA RIA, Sandoz) displayed reduced values in the child's blood (mother 864 ng/ml-4 hours after oral CsA intake; son 312 ng/ml). Beside postrenal failure the patient's pregnancy was complicated by 7 rejection episodes treated with high doses of methylprednisone (total dose 5 g) with reversible damage of the transplant function, two episodes of a urinary tract infection and increasing anemia necessitating blood transfusions. The HIV negative patient had developed a Kaposi's sarcoma 6 weeks after grafting. The progression of infiltrating skin lesions during pregnancy was not seen.
authors.affiliation: I. Medical Department, University of Vienna, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Derfler
authors.forename: A
authors.initials: A
authors.lastname: Schaller
authors.forename: C
authors.initials: C
authors.lastname: Herold
authors.forename: P
authors.initials: P
authors.lastname: Balcke
authors.forename: C
authors.initials: C
authors.lastname: Nowotny
authors.forename: R
authors.initials: R
authors.lastname: Walter
authors.forename: H
authors.initials: H
authors.lastname: Kopsa
authors.forename: M
authors.initials: M
authors.lastname: Endler
authors.forename: F
authors.initials: F
authors.lastname: Stockenhuber
authors.forename: K
authors.initials: K
authors.lastname: Kletter
mesh_terms: D000328:Adult; D003524:Cyclosporins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011256:Pregnancy Outcome; D014517:Ureteral Obstruction / Q000628:therapy
chemical_list: D003524:Cyclosporins