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Objectives There has been an increase in the number of pregnancies in renal transplant recipients. In recent years there has been a change from the option of immunosuppressive therapy in its patients. Unlike the previous standard of clinical care where cyclosporine was a common option, currently tacrolimus is the first choice in our group. However both options involve risks. Thus, our goal is a preliminary evaluation of maternal and perinatal outcomes of this new interaction. Methods Eighteen patients from January 2011 to December 2013 were evaluated as clinical, obstetrical and perinatal outcomes. All of them have used tacrolimus and azathioprine. Theirs results were compared with a cohort study (2001–2015) in our group where cyclosporine where the first choice. (Data from: Oliveira LG, Sass N et al. Pregnancy after renal transplantation. A five-yr single-center experience. Clin Transplant 2007;21:301–304). Results Tacrolimus group showed lower risk for chronic hypertension, preeclampsia, anemia and urinary infection, but with an increased rate of diabetes. Among perinatal outcomes, it had a higher risk of prematurity and small for gestational age babies (Table 1). Conclusions Considering the limitations of this preliminary analysis, it would not be possible to consider tacrolimus as a protective factor for the occurrence of hypertensive complications considering that its common adverse effects are nephrotoxicity and hypertension. However a higher incidence of diabetes was apparently confirmed. It should be considered that the rates of adverse outcomes are still higher than those observed in the general population, regardless of the type of immunosuppressive therapy. Further analyzes are needed seeking the best pattern to follow these patients to reduce maternal and perinatal risks. Support: FAPESP. Processo: 2014/00213-7. Disclosures N. Sass: None. J.L. Sato: None. T.A. Facca: None. V.A. Gomes: None. H.T. Silva Junior: None. M.R. Mesquita: None. H.A. Korkes: None. L.G. Oliveira: None. |
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