In pregnant women, the use of Mycophenolic acid (MPA) is associated with teratogenicity. Recently... more In pregnant women, the use of Mycophenolic acid (MPA) is associated with teratogenicity. Recently, the European Medicines Agency (EMEA) and the Spanish Agency of Medicine and Sanitary Products (AEMPS) warned about the potential teratogenic effects of MPA. These adverse events may occur even in children from males on treatment with MPA. However, evidence of malformations in offsprings of male kidney transplanted patients (KT) exposed to MPA is limited. Thus, the present study aimed to evaluate the incidence of offspring malformations in children of renal transplanted males under MPA. We conducted a retrospective study in which we evaluated the incidence of malformations in descendants from male recipients that were exposed or not to MPA before and at the time of conception. Two groups of patients were evaluated. Those exposed to MPA (MPA group, n = 20) and the non-MPA group (n = 13) that included patients that did not receive AZA (n = 5) and eight that did receive AZA (n = 8) at the ...
kidney allograft was retained in situ. KTRs were divided into those with a first kidney allograft... more kidney allograft was retained in situ. KTRs were divided into those with a first kidney allograft loss due to immunological factors and those with a first kidney allograft loss due to non-immunological factors. Samples were collected before transplantation, at +1, +2, and +3 months posttransplantation and alloreactive T-cells were measured using an interferon-c Elispot Assay. RESULTS: KTRs with nephrectomy of the failed kidney allograft show comparable patient survival compared with KTRs without nephrectomy, but a higher incidence of death from sepsis in the early posttransplant period. Among KTRs with a nonimmunological loss of the previous allograft, KTRs without nephrectomy show superior death-censored allograft survival, superior allograft function, less acute cellular rejection, and lower frequencies of alloreactive T-cells pre-and posttransplantation compared to KTRs with nephrectomy (p<0.05). No differences, however, were observed for delayed allograft function, the presence of preformed panel-reactive antibodies, and de novo donor-specific antibodies compared to KTRs with nephrectomy (p<0.05). KTRs with an immunological loss of the previous allograft show significantly inferior death-censored allograft survival compared to those with a nonimmunological cause of allograft loss (p=0.028). KTRs with the first kidney allograft retained in situ show a higher incidence of BK viremia and BK nephropathy compared to KTRs with nephrectomy of the previous allograft (p<0.05). CONCLUSIONS: Our results suggest superior allograft outcomes in KTRs with the first kidney allograft retained in situ after a non-immunological loss of the allograft. The observed lower alloreactivity may contribute to the observed excellent allograft outcomes. The presence of a failed allograft kidney may serve as origin for BK viremia.
In pregnant women, the use of Mycophenolic acid (MPA) is associated with teratogenicity. Recently... more In pregnant women, the use of Mycophenolic acid (MPA) is associated with teratogenicity. Recently, the European Medicines Agency (EMEA) and the Spanish Agency of Medicine and Sanitary Products (AEMPS) warned about the potential teratogenic effects of MPA. These adverse events may occur even in children from males on treatment with MPA. However, evidence of malformations in offsprings of male kidney transplanted patients (KT) exposed to MPA is limited. Thus, the present study aimed to evaluate the incidence of offspring malformations in children of renal transplanted males under MPA. We conducted a retrospective study in which we evaluated the incidence of malformations in descendants from male recipients that were exposed or not to MPA before and at the time of conception. Two groups of patients were evaluated. Those exposed to MPA (MPA group, n = 20) and the non-MPA group (n = 13) that included patients that did not receive AZA (n = 5) and eight that did receive AZA (n = 8) at the ...
kidney allograft was retained in situ. KTRs were divided into those with a first kidney allograft... more kidney allograft was retained in situ. KTRs were divided into those with a first kidney allograft loss due to immunological factors and those with a first kidney allograft loss due to non-immunological factors. Samples were collected before transplantation, at +1, +2, and +3 months posttransplantation and alloreactive T-cells were measured using an interferon-c Elispot Assay. RESULTS: KTRs with nephrectomy of the failed kidney allograft show comparable patient survival compared with KTRs without nephrectomy, but a higher incidence of death from sepsis in the early posttransplant period. Among KTRs with a nonimmunological loss of the previous allograft, KTRs without nephrectomy show superior death-censored allograft survival, superior allograft function, less acute cellular rejection, and lower frequencies of alloreactive T-cells pre-and posttransplantation compared to KTRs with nephrectomy (p<0.05). No differences, however, were observed for delayed allograft function, the presence of preformed panel-reactive antibodies, and de novo donor-specific antibodies compared to KTRs with nephrectomy (p<0.05). KTRs with an immunological loss of the previous allograft show significantly inferior death-censored allograft survival compared to those with a nonimmunological cause of allograft loss (p=0.028). KTRs with the first kidney allograft retained in situ show a higher incidence of BK viremia and BK nephropathy compared to KTRs with nephrectomy of the previous allograft (p<0.05). CONCLUSIONS: Our results suggest superior allograft outcomes in KTRs with the first kidney allograft retained in situ after a non-immunological loss of the allograft. The observed lower alloreactivity may contribute to the observed excellent allograft outcomes. The presence of a failed allograft kidney may serve as origin for BK viremia.
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