What a transplant story...Liver 1st, Intestines 2nd - followed by a baby!

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First

Child Born to Intestine Transplant Patient Reported: Presented at WTC

BOSTON, MA -- July 28, 2006 -- The first

child born to a woman who previously underwent an intestine transplantation was

reported here at the World Transplant Congress (WTC).

The woman, who was not identified, gave birth to the

healthy girl in May 2006, said Beverly Kosmach-Park, RN, transplant nurse,

Children's Hospital of Pittsburgh,

Pittsburgh, Pennsylvania.

The 23-year-old mother had previously

undergone 2 successful transplant procedures, Kosmach-Park said

in her poster presentation on July 26th. At the age of 30 months the woman required a liver transplant

due to biliary atresia. Complications associated with that

surgery required the removal of most of the intestines and an intestine transplant when she was 13 years old.

" Pregnancy after transplantation, particularly in renal and

liver transplant recipients, has been demonstrated to be well tolerated and

successful for a majority of patients, although still considered high-risk, "

Kosmach-Park said. " To date,

pregnancy has not been reported following intestine transplant. "

About 1,210 intestine transplants have been performed; about 658 of these

patients survive.

The doctors said that as far as they

know, there have been no other intestine transplant patients who have had

babies. Harmon, MD, former president of the American

Society of Transplantation and professor of pediatrics, Harvard Medical School,

Boston, Massachusetts, said he was not aware of any other babies born to women

with intestine transplantation, but noted that it is difficult to determine

definitively whether this was a first.

" The birth of the child

illustrates how far we have gone in making life as normal as possible for

transplant patients, " noted Dr. Harmon, who was not involved

in the case. " There is nothing more normal than pregnancy. "

In pregnancy, the body's natural rejection mechanism is turned off, he said, so

the reduction of antirejection drugs normally used to prevent organ rejection in

the pregnant woman did not appear to cause any problems during gestation,

reported the doctors who cared for the woman.

After receiving the intestine at age

13, the patient completed high school and was employed. She married in

September 2004. She suffered a miscarriage in 2005, but became pregnant again 5

months later.

Kosmach-Park reported that during the pregnancy immunosuppression was

maintained with tacrolimus monotherapy, allowing trough levels to fall to an

average of 3.8 ng/mL in the 3 to 6.3 range. Renal

function remained normal as did the woman's blood pressure and glucose levels.

She gained about 10.5 kg during the pregnancy.

The baby girl weighed 7 pounds, 3

ounces (3.3 kg) at birth. She showed traces of tacrolimus in her

blood until her third month postpartum. A surveillance endoscopy and biopsy of

the mother at 3 months postpartum revealed no evidence of rejection at 11.5

year post-transplant. Tacrolimus dose has been increased to a trough level of 6 to 10.3 ng/mL, Kosmach-Park reported.

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