title: High prevalence of ovarian cysts in premenopausal women receiving sirolimus and tacrolimus after clinical islet transplantation.
abstract: We encountered an unexpectedly high rate of ovarian cysts in premenopausal women receiving sirolimus and tacrolimus following islet transplantation. The goal of this retrospective chart review was to determine the frequency of ovarian cysts found on pelvic ultrasound examinations of female islet transplant recipients and to look for potential causal factors. Fifty-seven women with a median age of 42.5 years underwent islet transplantation at the University of Alberta. Ovarian cysts were found in 31 out of 44 (70.5%) premenopausal and two out of 13 (15.4%) postmenopausal women (P = 0.001). No women using combined oral contraception developed ovarian cysts. Eight women required surgery; in four women undergoing cystectomy or unilateral oophorectomy, ovarian cysts recurred. Sirolimus withdrawal was associated with a reduction in cyst size and resolution of cysts in 80% of subjects. The risk of ovarian cysts should be discussed with female islet transplant candidates and pelvic ultrasounds performed routinely post-transplant.
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: Eman
authors.initials: E
authors.lastname: Alfadhli
authors.forename: Angela
authors.initials: A
authors.lastname: Koh
authors.forename: Waleed
authors.initials: W
authors.lastname: Albaker
authors.forename: Ravi
authors.initials: R
authors.lastname: Bhargava
authors.forename: Thomas
authors.initials: T
authors.lastname: Ackerman
authors.forename: Charlotte
authors.initials: C
authors.lastname: McDonald
authors.forename: Edmond A
authors.initials: EA
authors.lastname: Ryan
authors.forename: A M James
authors.initials: AM
authors.lastname: Shapiro
authors.forename: Peter A
authors.initials: PA
authors.lastname: Senior
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D002170:Canada / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D010048:Ovarian Cysts / Q000453:epidemiology* / Q000601:surgery; D017698:Postmenopause; D017697:Premenopause; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D020123:Sirolimus / Q000009:adverse effects*; D016559:Tacrolimus / Q000009:adverse effects*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus