Borek-Dzieciol Beata, Czaplinska Natalia, Szpotanska-Sikorska Monika, Mazanowska Natalia, Wilkos Ewa, Jabiry-Zieniewicz Zoulikha, Pietrzak Bronislawa, Wielgos Miroslaw, Kociszewska-Najman Bozena
Department of Neonatology, Children's Hospital, Medical University of Warsaw, Poland.
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
Transplant Proc. 2020 Sep;52(7):1977-1981. doi: 10.1016/j.transproceed.2020.02.106. Epub 2020 Apr 14.
Being aware of the nephro- and hepatotoxic effects of most immunosuppressants, assessing their potential effects on the health of the offspring is an important aspect of deliberate family planning after organ transplantation.
The aim of the study was to evaluate the influence of immunosuppressive drugs used by pregnant women after kidney or liver transplantation on the lipid profile of their children.
Ninety-one children born to mothers after kidney or liver transplantation (study group) and 91 children of healthy mothers from the control group (control group) were included in the study. Transplant donors received immunosuppressive treatment in monotherapy or combination regimens during pregnancy. The study compared lipidogram values including total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides. The lipidogram was analyzed depending on the following 3 most commonly used immunosuppressive regimens: study group 1: CI (calcineurin inhibitors); study group 2: CI + GCs (glucocorticosteroids); and study group 3: CI + GCs + AZA (azathioprine).
There were no significant differences between study group and control group in mean total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglyceride levels (P > .05). In each of the studied subgroups, at least 1 abnormal lipidogram fraction was noted. Frequency of these deviations in study group 1, study group 2, and study group 3 were 31%, 57%, and 26%, respectively. However, no statistically significant differences were found between these obtained results (P > .05).
Prenatal exposure to immunosuppressants taken by the mother after liver or kidney transplantation does not appear to significantly affect the occurrence of lipid disorders in these children.
鉴于大多数免疫抑制剂具有肾毒性和肝毒性，评估其对后代健康的潜在影响是器官移植后计划生育的一个重要方面。
本研究旨在评估肾或肝移植后孕妇使用的免疫抑制药物对其子女血脂谱的影响。
本研究纳入了91名肾或肝移植母亲所生的子女（研究组）以及91名来自对照组的健康母亲所生的子女（对照组）。移植供体在孕期接受单一疗法或联合疗法的免疫抑制治疗。本研究比较了血脂谱值，包括总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯。根据以下3种最常用的免疫抑制方案分析血脂谱：研究组1：CI（钙调神经磷酸酶抑制剂）；研究组2：CI + GCs（糖皮质激素）；研究组3：CI + GCs + AZA（硫唑嘌呤）。
研究组和对照组在平均总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯水平上无显著差异（P > 0.05）。在每个研究亚组中，至少有1个血脂谱指标异常。研究组1、研究组2和研究组3中这些偏差的发生率分别为31%、57%和26%。然而，这些结果之间未发现统计学上的显著差异（P > 0.05）。
母亲在肝或肾移植后产前接触免疫抑制剂似乎不会显著影响这些儿童脂质紊乱的发生。
