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                          JeffNEWS, August 1, 1995
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Jefferson Study Evaluates Impact Of Transplants on Pregnancy 
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Female kidney transplant patients should continue to take immunosuppressive 
drugs during pregnancy and, in fact, may need to have their dosages of 
cyclosporine increased, according to an article in the current issue of the 
journal Transplantation. The study by researchers at Thomas Jefferson 
University indicates that patients with a well-functioning transplanted 
kidney may have a successful pregnancy.

Data for the study included 197 pregnancies in 141 female kidney transplant 
recipients.  Of the 197 pregnancies, 137 (68.2 percent) resulted in live 
births.  The information was collected as part of the National 
Transplantation Pregnancy Registry at Jefferson and was evaluated by Vincent 
T. Armenti, MD, PhD, a Jefferson transplant surgeon and lead author of the 
study, along with his team of investigators, with grant support from Sandoz 
Pharmaceuticals Corporation. 

The research focused on the effects between the pregnancy and the 
transplanted kidney.  All transplant patients require continuing treatment 
with immunosuppressive drugs such as cyclosporine in order to prevent 
rejection of the transplanted organ.

Patients in this study became pregnant while being treated with 
cyclosporine in combination with other immunosuppressive medications.  

These medications were taken throughout the pregnancy and during the 
follow-up period. 

The study sought to determine:  How does having a transplanted kidney 
affect the outcome of the pregnancy?; Should the dose of cyclosporine be 
changed during pregnancy?

The conclusions found that: 

  1) When mothers had well-functioning transplants, the birthweight of the 
     baby was higher than the weight of babies born to mothers whose
     transplants were not functioning as well;

  2) Complications of pregnancy, such as infection, can affect the long-
     term survival of the transplant;  

  3) During pregnancy, there are changes in metabolism and weight which 
     affect how much cyclosporine is available for the body to use. 

Pregnant patients who received a lower dose of cyclosporine before and 
during pregnancy were in the group whose babies had lower birthweight.  These 
patients were more likely to have failure of their transplanted kidney within 
two years of delivery.  The study showed that cyclosporine must be closely 
monitored for a better outcome in pregnant kidney transplant patients.

"This research indicates that close monitoring and careful dosing can 
result in a healthy pregnancy and birth," Dr. Armenti said.


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