[Immunosuppressive drug therapy during pregnancy after kidney transplantation]. / Leczenie immunosupresyjne kobiet ciezarnych z przeszczepiona nerka.

The authors expounded present state of knowledge concerning immunosuppressive drugs therapy during pregnancy after kidney transplantation. Pregnancy is uncommon in women with end-stage renal disease treated with dialysis and in most cases it ends with pregnancy failure. Resuming the normal function of the ovaries after kidney transplantation substantially increases the chances of conception and successful pregnancy. The immunosuppression scheme and dosage of drugs used in pregnant women are vital to both the normal course of pregnancy and delivery of a healthy child. Considering the safety of the fetus it is acceptable to use prednisone, azathioprine, cyclosporine and tacrolimus. Due to the necessity to administer immunosuppressive drugs in relatively small doses, an important factor conditioning the normal course of pregnancy is maintaining a 1- or 2-year interval between the kidney transplantation and the conception.

[Antiphospholipid antibodies in the transplanted kidney pathology]. / Przeciwciala antyfosfolipidowe w patologii przeszczepionej nerki.

The purpose of the paper was to estimate clinical problems of the antiphospholipid antibodies (PAF), the mechanisms of their development and function in general thrombotic complications. Special attention has been paid to thrombotic complications in the transplanted kidney. In the group of patients with early renal allograft failure PAF are more frequent than in patients with functioning grafts. The presence of antiphospholipid antibodies in patients prior to the transplantation may indicate the patients' susceptibility to thrombotic complications and failure of the transplanted kidney function. In the case of less intensive coagulation the lifetime of the functioning kidney may be considerably shortened. So far, no satisfactory anticoagulation therapy has been developed. Patients were treated with warfarin, heparin as well as fractionated heparin and intravenous immunoglobulin, aspirin and prednisone. The anticoagulation therapy should be applied in compliance with the laboratory markers of coagulation and with special emphasis put on the general health status of a patient.

[Evaluation of congenital infection risk on the basic of cytokines Il-1 beta, Il-6 and TNF alpha levels in blood serum and amniotic liquid in pregnant women and in umbilical blood of neonates]. / Ocena zagrozenia zakazeniem wrodzonym u noworodków w oparciu o wartosci cytokin: IL-1 beta, IL-6 i TNF alpha w surowicy krwi i plynie owodniowym ciezarnych oraz we krwi pepowinowej noworodków.

OBJECTIVE: The aim of the study was to evaluate congenital infection risk on the basic of cytokines IL-1 beta, IL-6 and TNF alpha levels in blood serum and amniotic liquid in pregnant women and in umbilical blood of neonates. MATERIALS AND METHODS: The study was carried out on 37 women in labor including 17 mothers with normal pregnancy (group A-test) and 20 suspected of intrauterine infection (group C). There have been indicated cytokines IL-1 beta, IL-6 and TNF alpha in amniotic liquid and in blood serum collected in the second stage of labor and in umbilical blood serum. The accepted procedure used in our study resulted from the assumption that the analysis of cytokines in amniotic liquid collected without amniocentesis was beneficial. RESULTS: It has been proved that among women in labor from group C there is a high concentration of IL-6 and TNF alpha in amniotic liquid that has statistic significance as far as markers for women with normal pregnancy are concerned (group A). Lower levels of IL-6 than in amniotic liquid but statistically meaningful in relation to the markers in group A have been detected in serum collected from pregnant women and in the umbilical blood of the neonates. Among 18 neonates delivered by mothers from group C the symptoms of congenital infection have appeared. CONCLUSION: Extending diagnostics of congenital infection on the basis of the analyzed cytokines, mainly IL-6 in the second stage of labor, is of prognostic significance.