title: Alterations of the female reproductive system in recipients of islet grafts.
abstract: 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.
authors.affiliation: Diabetes Research Institute, University of Miami School of Medicine, 1450 NW 10 Avenue, Miami, FL 33136, USA.
authors.forename: Pablo
authors.initials: P
authors.lastname: Cure
authors.forename: Antonello
authors.initials: A
authors.lastname: Pileggi
authors.forename: Tatiana
authors.initials: T
authors.lastname: Froud
authors.forename: Paul M
authors.initials: PM
authors.lastname: Norris
authors.forename: David A
authors.initials: DA
authors.lastname: Baidal
authors.forename: Agustin
authors.initials: A
authors.lastname: Cornejo
authors.forename: Muhammad M
authors.initials: MM
authors.lastname: Hafiz
authors.forename: Gaston
authors.initials: G
authors.lastname: Ponte
authors.forename: Raffaella
authors.initials: R
authors.lastname: Poggioli
authors.forename: Jeannie
authors.initials: J
authors.lastname: Yu
authors.forename: Amanda
authors.initials: A
authors.lastname: Saab
authors.forename: Gennaro
authors.initials: G
authors.lastname: Selvaggi
authors.forename: Camillo
authors.initials: C
authors.lastname: Ricordi
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Alejandro
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone