Alterations of the female reproductive system in recipients of islet grafts.
BACKGROUND
Transplantation of allogeneic tissues is becoming a wider practice for the replacement of organ function lost to congenital or acquired pathologies. Chronic immunosuppression remains a necessity to prevent organ rejection, despite increased risks of infection, organ toxicity, and malignancies. Abnormalities of female gonadal function in patients of reproductive age are recognized, however, pathological alterations of the reproductive system in patients treated with new generation immunosuppressive drugs are still poorly documented.


METHODS
We report herein our observations of abnormalities of the reproductive system in 13 female recipients of allogeneic islets for type 1 diabetes, under immunosuppression therapy based on daclizumab induction and tacrolimus/sirolimus maintenance.


RESULTS
Menstrual cycle alterations and clinically significant ovarian cysts were frequently observed in our patients, some requiring medical or surgical intervention. All ovarian cysts appeared of benign nature.


CONCLUSIONS
Our findings suggest that pre- and posttransplant evaluation of female patients should include menstrual history, baseline pelvic ultrasound, and hormonal levels to assess the presence and monitor the progression of such alterations.
Cure
Pablo
P
Diabetes Research Institute, University of Miami School of Medicine, 1450 NW 10 Avenue, Miami, FL 33136, USA.
Pileggi
Antonello
A
Froud
Tatiana
T
Norris
Paul M
PM
Baidal
David A
DA
Cornejo
Agustin
A
Hafiz
Muhammad M
MM
Ponte
Gaston
G
Poggioli
Raffaella
R
Yu
Jeannie
J
Saab
Amanda
A
Selvaggi
Gennaro
G
Ricordi
Camillo
C
Alejandro
Rodolfo
R
D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects*; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle; D008875:Middle Aged; D010048:Ovarian Cysts / Q000209:etiology; D010053:Ovary / Q000503:physiopathology*; D010388:Pelvis / Q000000981:diagnostic imaging; D011374:Progesterone / Q000097:blood; D014463:Ultrasonography
D007166:Immunosuppressive Agents; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone