Outcome of twin pregnancy in a renal transplant recipient treated with tacrolimus.
Our report describes the outcome of a twin pregnancy in a woman who was maintained on tacrolimus after a living related renal transplant. Both babies born at 32 weeks of gestation developed severe respiratory distress requiring ventilator assistance and went on to develop congestive heart failure. Echocardiograms on both babies showed dilated heart chambers. Twin A succumbed to complications, but twin B, who was treated more aggressively with vasopressors, recovered. Autopsy findings on twin A revealed a thrombotic cardiomyopathy with degeneration of cardiac muscle. We believe that the unusual outcome in this set of twins may have been a result of cardiomyopathy secondary to tacrolimus used by the mother during her pregnancy.
Division of Pediatric Nephrology, SUNY Health Science Center at Brooklyn, New York 11203, USA.
S
S
Vyas
A
A
Kumar
S
S
Piecuch
G
G
Hidalgo
A
A
Singh
V
V
Anderson
M S
MS
Markell
N
N
Baqi
D001379:Azathioprine / Q000627:therapeutic use; D002585:Cesarean Section; D016572:Cyclosporine / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D006973:Hypertension; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007231:Infant, Newborn; D007234:Infant, Premature; D016030:Kidney Transplantation / Q000276:immunology; D007741:Labetalol / Q000627:therapeutic use; D019520:Living Donors; D008297:Male; D009679:Nuclear Family; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*; D014427:Twins
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine; D007741:Labetalol; D011241:Prednisone; D016559:Tacrolimus