Hypothalamic-pituitary-gonadal axis function after successful kidney transplantation in men and women.
BACKGROUND
Renal transplantation (RT) is the most common solid organ transplant procedure. Several studies have reported on gonadal function in male and female RT recipients with controversial results.


METHODS
Forty consecutive patients (20 male, 20 female) with a fully functioning allograft (serum creatinine 0.8-1.3 mg/dl) for at least 15 months after RT were included in the study. Their ages ranged from 23 to 44 years (median 38) and their post-RT follow-up lasted 15-86 months (median 23). FSH, LH, prolactin, 17-beta-estradiol, testosterone, androstenedione and dehydroepiandrostrone were determined in all patients and compared with a group of 80 healthy subjects. Pelvic ultrasonography was performed in all participants.


RESULTS
Testosterone was below the normal range in 70% of male patients and within the lowest third in the remainder; a lack of LH increase indicated an inhibition of the reproductive axis. Male testosterone values were negatively influenced by calcineurine inhibitors treatment (P < 0.005), but positively influenced by a better graft function (P < 0.0001). Testicular and prostate volumes were reduced with respect to controls, with the latter related to circulating testosterone levels. Ten of the women (50%) had menstrual cycle disorders after RT, three being affected by transient, and three by persistent, amenorrhea. Another two patients had had transient polymenorrhea. In four women (20%), a premature ovarian failure was diagnosed. No relationship was found between female reproductive function and age, graft function or duration of the post-transplant period. Prolactin was lower in patients on calcineurin inhibitors (P < 0.01).


CONCLUSIONS
Abnormalities of the reproductive system were frequent after successful RT in both genders.
Tauchmanovà
Libuse
L
Department of Molecular and Clinical Endocrinology and Oncology, University Federico II of Naples, Cantazaro, Italy. colao@unina.it
Carrano
Rosa
R
Sabbatini
Massimo
M
De Rosa
Michele
M
Orio
Francesco
F
Palomba
Stefano
S
Cascella
Teresa
T
Lombardi
Gaetano
G
Federico
Stefano
S
Colao
Annamaria
A
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006066:Gonads / Q000503:physiopathology*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000009:adverse effects; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008599:Menstruation Disturbances / Q000209:etiology; D010053:Ovary / Q000000981:diagnostic imaging; D011184:Postoperative Period; D016649:Primary Ovarian Insufficiency / Q000209:etiology; D011467:Prostate / Q000000981:diagnostic imaging; D013737:Testis / Q000000981:diagnostic imaging; D013739:Testosterone / Q000097:blood; D016896:Treatment Outcome; D014463:Ultrasonography
D013739:Testosterone; D007986:Luteinizing Hormone