John Libbey Eurotext

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Pregnancies and immunosuppressive treatment: the first 50 years Volume 15, issue 2, Avril-Mai-Juin 2013

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Service de néphrologie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France

It is now 50 years that the first pregnancy has been reported in a solid organ transplant recipient. The observations made during these years have demonstrated that such pregnancies may have a favorable outcome. However, many questions need well-conducted studies. Before the pregnancy, a delay between one and two years is mandatory with a stable transplant function and stable immunosuppressive regimen. The follow-up of ongoing pregnancies implies a multidisciplinary approach including immunologists, transplant physicians and obstetricians. The information regarding the higher risk of miscarriages, cesarean section and preterm birth must be given to recipients. The consequences on the graft are still a matter of debate. Regarding teratogenic complications, avoidance of specific immunosuppressive or antihypertensive treatments is mandatory. The results of large registry are positive even though some questions persist regarding the long-term immunologic or neurocognitive consequences of immunosuppressive treatment during pregnancies.