October 24, 2013
Stopping Transplant Drugs Before Conception Benefits Fetus
Discontinuing mycophenolate acid products does not seem to pose risks of transplant rejection
Research suggests that fetal exposure to mycophenolic acid products (MPA)—which are drugs taken by transplant recipients to prevent rejection—may increase the risk of birth defects and spontaneous abortions. Results of this study will be presented at ASN Kidney Week 2013 November 5-10 at the Georgia World Congress Center in Atlanta, GA.
To investigate these potential links, Serban Constantinescu, MD, PhD (Temple University School of Medicine) and his colleagues analyzed data from the National Transplantation Pregnancy Registry (NTPR), comparing 163 female kidney transplant recipients who discontinued MPA prior to conception with 114 recipients who conceived while taking MPA.
In recipients who discontinued MPA, there were more live births (79% vs. 43%), a lower incidence of miscarriages (19% vs. 52%), and a lower incidence of birth defects (6% vs. 14%). Kidney problems during and after pregnancy were similar in the two groups of transplant recipients.
"The results of this study generate multiple questions. Continued close collaboration among specialists will help to better identify potential pregnancy risks in kidney transplant recipients, particularly as new immunosuppressive agents are developed," said Dr. Constantinescu. "Individual physicians and transplant centers are encouraged to report all pregnancy exposures in transplant recipients to the National Transplantation Pregnancy Registry, which was designed specifically to assess the safety of pregnancy in solid organ transplant recipients."
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