Burrows D A, O'Neil T J, Sorrells T L
Department of Obstetrics and Gynecology, David Grant United States Air Force Medical Center, Travis Air Force Base, California.
Obstet Gynecol. 1988 Sep;72(3 Pt 2):459-61.
Cyclosporine A has recently been reported to be an effective immunosuppressant agent for use in renal allograft recipients. Questions have been raised regarding its effects during pregnancy, in light of an increased life span and return of fertility in renal transplant patients. A preterm delivery is reported in a cadaveric renal allograft recipient chronically immunosuppressed with cyclosporine A and methylprednisolone. Dizygotic twins were delivered at 35 weeks' gestation, weighing 2452 and 2386 g. Maternal cyclosporine A levels were determined weekly by whole blood radioimmunoassay, with little increase in requirement found before delivery. No indication of maternal renal compromise was apparent, as evidenced by stable weekly creatinine clearance studies. Cyclosporine A, at the doses used, was passed transplacentally, with cord blood values of 34 and 57% of the maternal cyclosporine A level found at delivery. No adverse effects were noted at birth in the average for gestational age neonates, nor at nine-month follow-up evaluation. Given careful monitoring, cyclosporine A may be an effective immunosuppressant agent for use in pregnancies complicated by renal transplantation.
最近有报道称环孢素A是一种用于肾移植受者的有效免疫抑制剂。鉴于肾移植患者寿命延长和生育能力恢复，人们对其在孕期的影响提出了疑问。据报道，一名接受尸体肾移植的患者长期使用环孢素A和甲基强的松龙进行免疫抑制，出现了早产情况。该患者在妊娠35周时产下了一对异卵双胞胎，体重分别为2452克和2386克。通过全血放射免疫分析法每周测定母体环孢素A水平，发现分娩前其需求量几乎没有增加。每周的肌酐清除率研究结果稳定，表明母体肾功能没有受损迹象。所使用剂量的环孢素A通过胎盘传递，脐带血中环孢素A的值为分娩时母体环孢素A水平的34%和57%。对于孕周合适的新生儿，出生时未发现不良反应，在9个月的随访评估中也未发现不良反应。经过仔细监测，环孢素A可能是用于肾移植合并妊娠的一种有效免疫抑制剂。
