[Successful outcome of high-risk pregnancy within 1 year following kidney transplantation with cyclosporin as the immunosuppressive agent].

A 41-year-old female patient with analgesic nephropathy became pregnant 13 weeks after successful renal transplantation using cyclosporin as an immunosuppressant. Because of rhesus incompatibility of the mother this was thought to be a high risk pregnancy. In spite of the increased risk of CyA-induced nephrotoxicity in this early phase after transplantation, the patient showed the same physiological renal changes during pregnancy as healthy control patients: a 24% increase in creatinine clearance and an increase in protein excretion of only 41 mg/day. To maintain a CyA-blood concentration of 200-600 ng/ml throughout the pregnancy the CyA dose had to be increased from 380 to 550 mg daily or from 6.9 to 8.3 mg/kg/day (20%). This increase in CyA requirement may indicate additional metabolism of CyA by the fetal liver.