K Bobrowska

Medical University of Warsaw, Warsaw, Masovian Voivodeship, Poland

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Publications (26)27.32 Total impact

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    ABSTRACT: Transfusion-related acute lung injury (TRALI) is a rare, but potentially fatal, complication of blood product transfusion, manifesting as acute respiratory distress syndrome. In most cases, TRALI is associated with massive transfusion of fresh frozen plasma and platelets.
    Ginekologia polska 08/2014; 85(8):635-8. · 0.79 Impact Factor
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    ABSTRACT: Background: Pregnancies in graft recipients are associated with increased risk of a number of pathologies. The aim of the study was to analyze results of brain and abdominal ultrasonography and echocardiography (ECHO) in neonates born to liver (LTx) or renal recipients (RTx). Material/Methods: The study group consisted of 82 neonates born to transplanted women (46 neonates of liver recipients and 36 neonates of renal recipients), enrolled in a retrospective study. The control group consisted of 74 neonates from the general population. Sonographic examination of the brain was performed to check for the presence of intra-/periventricular hemorrhage (IVH/PVH) according to Papile, and periventricular leukomalacia (PVL).The results of abdominal ultrasonography and 2-dimensional echocardiography (ECHO) were compared between the groups. The immunosuppressive therapy used during pregnancy was also analyzed. Results: No significant differences were observed between the frequency of IVH in LTx and RTx groups and LTx, RTx, and control groups. Abdominal ultrasonography revealed 1 case of suprarenal hemorrhage, 1 case of cystic kidney, and 3 cases of pyelocalyceal system dilatation in the study group. There were no abnormalities in the echocardiography in 97.8% of children born to mothers after LTx and in 94.4% after RTx. There were significant differences in the immunosuppressive therapy between the pregnant women after LTx and RTx. Conclusions: The risk was not increased in intra-/periventricular hemorrhage and congenital abnormalities of the gastrointestinal tract and heart in neonates of mothers after organ transplantation, regardless of the immunotherapy used, and risk was similar to that of the general population.
    Annals of transplantation: quarterly of the Polish Transplantation Society 12/2012; 17(4):113-9. · 0.82 Impact Factor
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    ABSTRACT: We present a case of a female kidney recipient who was infected with 3 types of high-risk human papilloma viruses. An infection in the lower genital tract led to the development of both neoplastic cervical lesions and vulvar cancer.
    Transplantation Proceedings 10/2011; 43(8):2994-6. · 0.95 Impact Factor
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    ABSTRACT: End-stage liver failure is associated with severe abnormalities in menstrual and reproductive function. These abnormalities may be reversed by successful orthotopic liver transplantation (OLT). The aim of the study was to investigate menstrual patterns and sex hormone profiles among female liver transplant recipients of reproductive age. The study group consisted of 24 women of reproductive age with end-stage liver failure who underwent successful OLT. Menstrual patterns and sex hormone profiles were analyzed before as well as 3 and 12 months after OLT. Twenty-seven healthy women of reproductive age served as controls. Biochemical parameters of liver function were assessed before and after OLT. Amenorrhea was the most commonly observed abnormality of menstrual cycle in women with end-stage liver failure (71% of patients). The recurrence of regular menstrual cycles was observed in 35% of patients 3 months after OLT. The percentage increased to 70% at 1 year after grafting and was clearly associated with stabilization of liver function. Similar levels of follicle stimulation hormone (FSH), luteinizing hormone (LH), prolactine (PRL), and testosterone (T) as well as lower levels of estradiol (E(2)), dehydroepiandrostendione sulphate (DHEA-S), and progesterone, (P) were observed in patients with liver failure compared with healthy women. We observed normalization of E(2) and DHEA-S levels after OLT. Amenorrhea, the most common menstrual disturbance in women with end-stage liver failure, may be reversed by OLT. One year after OLT menstrual bleedings were noted in 74% of patients of reproductive age. The recurrence of reproductive function indicated the need for effective and safe family planning methods in that group of patients.
    Transplantation Proceedings 07/2009; 41(5):1735-9. · 0.95 Impact Factor
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    ABSTRACT: Ovarian function with regular menstrual cycles is usually restored in women of reproductive age after solid organ transplantation. The number of pregnancies reported in these patients increases gradually. Pregnancy is always considered high risk, and not properly planned may lead to serious complications. The best for the patient is to conceive in a period of good general health and good stable graft function, after appropriate preparation and not later than five years after transplantation. Immunosuppressive regimen should be modified before conception. Sirolimus and mycophenolate mofetil should be excluded. The blood levels of immunosuppressive agents should be regularly controlled during the whole pregnancy. The rate of successful pregnancies isn approximately 95% in graft recipients. Increased incidence of preterm labor, anemia and intrauterine growth restriction is observed compared with general population. Organ transplantation itself is not an indication for cesarean section and vaginal delivery is recommended as the best for the patient, the graft and the newborn. Breast feeding is believed to be contraindicated in women on immunosuppressive therapy, however no adverse effects were reported in children of graft recipients who decided to breast feed. The rate of congenital malformations in newborns is approximately 3-4% and does not differ from the rate seen in general population. The rate of perinatal deaths decreased beneath 0.8% in recent reports. Jaundice, hyperglycemia and hyperkalemia, observed more frequently in newborns of graft recipients, are mild and in most cases do not have any clinical implications.
    Neuro endocrinology letters 03/2009; 30(1):6-10. · 0.93 Impact Factor
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    ABSTRACT: Organ transplantation has become universally accepted treatment of end-stage organ failure. The main problem focuses on preventing the graft from rejection with the use of immunosuppressive agents. High incidence of infection is the most frequent adverse effect of immunosuppressive therapy. Symptoms of inflammation are often reduced in immunosuppressed patients. All invasive diagnostic and therapeutic procedures should be associated with the increase in dose of steroids and prophylactic antibiotics. Ovarian and menstrual function is usually restored in transplanted women. Function of the hypothalamus-pituitary-ovary axis in transplanted women is believed to be normal. Most common abnormal uterine bleeding in graft recipient are: prolonged and profuse menstruation and inter-menstrual bleeding or spotting. Among the underlying diseases are lesions of the uterus (fibroids, endometrial or cervical polyps), infections of sex organs or hormonal disturbances. Higher rate of endometrial hyperplasia (without atypia) is reported in renal graft recipients. Organ transplantation results in the restored fertility thus effective family planning method is necessary in women of reproductive age who do not want to conceive. Vaginal diaphragms are not advised and intrauterine device are contradicted. Observational studies indicate for safety and high rate of acceptance of oral and transdermal hormonal contraception in transplanted women. Over ten-year experiences of HRT administration in graft recipient have proved the benefits of the therapy. Patients after organ transplantation have three to four-fold increased incidence of malignancy compared with general population. All transplant women must undergo regular gynecological screening for premalignant and malignant lesions of sex organs and breast.
    Neuro endocrinology letters 01/2009; 29(6):852-6. · 0.93 Impact Factor
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    ABSTRACT: The high rate of abnormal uterine bleeding associated with endometrial hyperplasia has been observed in women after kidney transplantation. The great majority of these premalignant lesions regress after conservative treatment, mostly with progestagens. There are cases, however, of persistent or recurrent hyperplasia requiring operative treatment. We report seven cases of endometrial hyperplasia in kidney graft recipients treated with hysterectomy after failure of conservative treatment. The presence of typical risk factors of endometrial hyperplasia and cancer were analyzed as well as their clinical courses and treatment methods. The age of the patients ranged from 35 to 50 years (mean, 42.7). Among typical risk factors, we observed obesity, diabetes, arterial hypertension, and nulliparity in the study group. All patients reported abnormal uterine bleeding and developed anemia. Women underwent two to four dilatation and curettage procedures. Progestagens (medroxyprogesterone or lynesterol) were administered for 3 to 9 months. The initial treatment was ineffective in two cases; in the remaining five cases endometrial hyperplasia recurred within 3 to 12 months. Pathologic findings after hysterectomy in all patients confirmed non-atypical endometrial hyperplasia. Hysterectomy is the treatment of last resort for premalignant endometrial lesions. It should be considered in all cases of recurrent or persistent endometrial hyperplasia. It may protect immunocompromised kidney graft recipients from heavy bleeding, severe anemia, and most of all, the of endometrial cancer development.
    Transplantation Proceedings 12/2007; 39(9):2756-8. · 0.95 Impact Factor
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    ABSTRACT: The aim of the study was to assess the safety of low-dose oral or transdermal hormonal contraception in kidney recipients. Twenty-six kidney recipients, aged 18 to 44 years (mean, 31.0) took low-dose contraceptive pills, and 10 kidney recipients, aged 22 to 36 years (mean, 31.4) used transdermal contraceptive systems. Contraception was administered for a period not shorter than 18 months. At the onset of therapy all patients showed stable graft function. The main indication for therapy was effective contraception. Additional indications were mild ovarian cysts and irregular or profuse menstruations. The pills consisted of 20 to 35 microg of etinyl estradiol and generation III progestogen. The contraceptive patch released 20 microg of etinyl estradiol and 150 microg of norelgesromin daily. No case of pregnancy was noted. Oral contraception was discontinued in two cases, in one case due to profound thrombophlebitis of the lower extremity and in the other case deterioration of liver function. No other side effects or symptoms of intolerance were reported. Hormonal contraception did not significantly influence body mass index, mean blood pressure, serum creatinine, or other biochemical parameters. Despite the presence of relative contraindications, mainly arterial hypertension and impaired liver function, hormonal contraception should be considered in female kidney recipients to be a highly effective contraceptive method that additionally regulates menstrual bleeding, protects from development of mild ovarian cysts and seems to positively influence women's well-being. The transdermal mode of administration may diminish the chance for drug interactions and therefore be safer for patients.
    Transplantation Proceedings 12/2007; 39(9):2759-62. · 0.95 Impact Factor
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    ABSTRACT: A high rate of cesarean sections has been reported among high-risk pregnancies in liver transplant recipients. The aim of this study was to analyze the course of deliveries and the indications for cesarean sections in women after liver transplantation. From 2001 to 2006, we noted 21 deliveries in 17 liver recipients. The mean age of women was 27.9 +/- 6.6 years and the mean time from transplantation to pregnancy was 4.3 +/- 3.6 years. Most patients were primigravidas on tacrolimus-based immunosuppressive regimens. We retrospectively analyzed obstetric data regarding the delivery and the early puerperium. We noted 6 vaginal deliveries (29%) and 15 cesarean sections (71%). Mean gestational age in the group of vaginal deliveries was 37.6 +/- 2.2 weeks. No labor complications were noted. All neonates were delivered in a good state (Apgar score from 8 to 10 points) with mean birth weight of 2725 g. All cesarean sections were performed for obstetric indications: fetal distress, breech presentation, intrauterine growth retardation, or complications related to premature labor. Mean gestational age was 37.0 +/- 1.9 weeks. The Apgar scores ranged from 4 to 10 points; mean birth weight was 2787 g. The mean period of hospitalization after surgical labor was 4 days longer compared with the vaginal delivery group. The high rate of cesarean sections (71%) in liver recipients is associated with a great incidence of obstetric complications of pregnancy. Safe and uneventful vaginal delivery is possible with growing experience in the management of pregnant transplanted women.
    Transplantation Proceedings 12/2007; 39(9):2796-9. · 0.95 Impact Factor
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    ABSTRACT: End-stage liver failure is associated with extremely reduced fertility. After liver transplantation, restoration of menstrual function is observed; thus effective contraceptive methods should be employed in patients who do not plan to conceive. The aim of this study was to assess tolerability and safety of hormonal contraceptives in female liver transplant recipients. We retrospectively analyzed data on 15 female liver graft recipients, aged 24 to 35 years, who used hormonal contraceptives after liver transplantation for a time not shorter than 12 months. The period from grafting to administration of hormonal contraceptives varied from 6 months to 7 years. Biochemical parameters of liver function, fasting glucose levels, body mass index (BMI) as well as blood pressure were monitored at 0, 3, 6, and 12 months of therapy. Side effects of the treatment were noted on regular follow-up examinations. No case of pregnancy or graft rejection was observed on therapy. Changes of biochemical parameters were not significant (aspartate transferase 22.92 +/- 6.67 vs 25.54 +/- 7.90, alanine transferase 22.08 +/- 5.66 vs 24.27 +/- 7.57, total bilirubin 0.96 +/- 0.17 vs 1.02 +/- 0.15). Blood pressure and BMI remained stable in the group. None of the patients discontinued therapy for medical indications. Hormonal contraception was administered as soon as liver transplant function was stable. It was effective, well tolerated, and did not seem to impair graft function. However, a long-term prospective study is necessary to assess the safety of hormonal contraception in transplant recipients.
    Transplantation Proceedings 07/2007; 39(5):1530-2. · 0.95 Impact Factor
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    ABSTRACT: Excellent long-term outcomes of transplant patients let many female liver-recipients experience perimenopausal problems. This study assessed menstrual patterns and sex hormone profiles in women of perimenopausal age who experienced end-stage liver failure treated by transplantation (OLT). Menstrual patterns, sex hormone profiles, and biochemical parameters of liver function were analyzed before and after OLT in 13 liver-transplanted patients of perimenopausal age. Nineteen healthy perimenopausal women served as controls. The most common abnormality of the menstrual cycle observed in the study group was secondary amenorrhea, which affected six liver-transplanted women. Three months after OLT amenorrhea was still observed in six patients, regular menstrual cycles in six and irregular bleeding in one graft recipient. One year after transplantation regular menstruations were noted in four, irregular bleeding in four, and secondary amenorrhea in five liver-transplanted women. Similar levels of follicle stimulating hormone, luteinizing hormone, prolactin, progesterone and testosterone as well as lower levels of estradiol and DHEA-sulfate were observed in patients with liver failure, both before and after grafting, compared with healthy women. After OLT E2 levels increased from 32.05 +/- 18.04 to 49.12 +/- 22.21. One year after OLT disturbances in menstrual patterns affect most (69%) perimenopausal female liver recipients. Both before and after OLT significantly lower levels of estradiol and DHEA-S were observed in transplanted patients compared with healthy controls. Hormonal therapy of amenorrhea or irregular menstruations may be required in that group of patients.
    Transplantation Proceedings 12/2006; 38(9):2909-12. · 0.95 Impact Factor
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    ABSTRACT: To assess safety of combined low-dose oral contraceptives in women after renal transplantation. Twenty six female renal graft-recipients, aged from 18 to 44 (mean 31 years), who used combined low-dose oral contraceptives after renal transplantation for at least 18 months were enrolled in the study. All patients had stable graft function with mean serum creatinine of 1.3 mg/dl. In 58% of women effective contraception was the mean indication for the therapy, in the remaining group pills were indicated additionally for the development of ovarian cysts and excessive menstrual bleedings. Ethinyl estradiol dose was 20 mug in 73% of cases and 30-35 microg in the remaining group. No case of pregnancy was observed. Contraceptive therapy was discontinued in two cases: for profound vein thrombosis in one and deterioration of liver function in the other case. No side effects of contraceptives were observed in the remaining group of patients within at least 18-month observational period. No case of ovarian cyst was reported. Oral contraceptives were not found to influence body mass index (BMI), mean blood pressure, serum creatinine and biochemical parameters (AST, ALT, total bilirubin, glucose and cholesterol). Despite the presence of relative contraindications for hormonal drugs (arterial hypertension and deteriorated liver function) in female renal recipients, administration of combined low-dose contraceptive pill should be taken into account as highly effective contraceptive method, that additionally regulates menstrual bleeding patterns, protects from ovarian cysts development and improves life quality of the patient.
    Neuro endocrinology letters 11/2006; 27(5):679-82. · 0.93 Impact Factor
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    ABSTRACT: The preliminary study was performed to evaluate the diagnostic accuracy of saline infusion sonohysterography (SIS) in the detection of intrauterine pathologies in infertile women The SIS findings were compared to the results of two widely used procedures: transvaginal sonography (TVS) and hysteroscopy (HS). 68 infertile women, aged 27-42 were enrolled in the study. TVS, SIS and diagnostic HS were consecutively performed in every patient. The results of each method were compared. Sensitivity, specificity, positive predictive value and negative predictive values for TVS and SIS were obtained. Intrauterine pathologies were diagnosed in 25% of patients. TVS detected 6 (37.5%) and SIS revealed 11 (87.5%) of 13 intrauterine pathologies finally visualized at diagnostic hysteroscopy. TVS failed to visualize three submucous myomas, one endometrial polyp and two cases of septate uteri. All three cases of intrauterine synechiae were not detected with this method One submucous myoma and one endometrial polyp were not identified with SIS. The study group was, however, too limited to show statistically significant differences in diagnostic accuracy among TVS, SIS and HS. Saline infusion sonohysterography is simple, sensitive and inexpensive diagnostic method. The procedure is not time-consuming, causes minimal discomfort to the patient and may be performed without anesthesia in office settings. The method may be recommended for the diagnosis of intrauterine pathologies in infertile women.
    Neuro endocrinology letters 09/2006; 27(4):523-8. · 0.93 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 08/2006; 28(4):566 - 566. · 3.56 Impact Factor
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    ABSTRACT: The assessment of efficacy and safety of two regimens of hormonal replacement therapy (HRT) in women after kidney transplantation with climacteric symptoms. Combined transdermal or transdermal-oral hormonal replacement therapy was administered to 86 kidney-transplanted women, aged 31-52 years, with moderate to severe climacteric symptoms in years 1995-2005. The patients underwent follow-up examinations one, three and six months after onset of the therapy and every four months subsequently. Blood pressure, body weight, sex hormone profile, serum parameters of both kidney and liver function, endometrial image in transvaginal sonography and reduction of climacteric symptoms were assessed. The mean time of the therapy was 5.6 years for transdermal-oral regimen (54 patients) and 4.7 years for transdermal regimen (32 patients). Most patients reported reduction of climacteric symptoms and improved life quality after 6 months of HRT. 28% of women discontinued therapy for medical indications, most often due to significant deterioration of liver function. One case of profound vein thrombosis was noted. 21% of women decided to discontinue therapy after the results of the WHI trial had been published. Hormonal replacement therapy is effective in climacteric symptoms relief and improvement of life quality in kidney transplanted women. Higher rate of side effects observed in that group of patients contributes to the need for frequent, attentive surveillance. Further studies should be conducted to establish the optimal doses and routes of administration of HRT as well as to assess the range of necessary follow-up examinations.
    Neuro endocrinology letters 07/2006; 27(3):387-91. · 0.93 Impact Factor
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    ABSTRACT: End-stage renal failure is associated with amenorrhaea and extremely reduced fertility. After successful kidney transplantation restoration of menstrual function is observed. The aim of the study was to investigate ovarian function and menstrual cycles in kidney-transplanted women of reproductive age. 55 ovarian cycles in kidney transplanted women, aged 18-40 years, being one to five years after transplantation, were analyzed and compared with 50 cycles of healthy women. The duration of the cycles as well as FSH, LH, estradiol, progesterone, prolactin and testosterone serum concentrations were monitored. Simultaneously the presence of ovulation was evaluated with repeated sonographic examinations. Regular menstrual cycles were observed in 72.7% of kidney transplanted women. The rates of ovulatory cycles were similar in the study group and the control: 65% and 70% respectively. Mean estradiol level in the follicular phase of the cycle was significantly higher in transplant patients (205.9, SD 160.22 vs 135.9 pg/ml, SD 68.34 in the control). Significantly lower levels of progesterone (13.2 ng/ml, SD 14.2 vs 26.7 ng/ml, SD 14.1 in the control) and testosterone were observed in kidney recipients. Other hormonal parameters did not differ significantly between the groups. The rate of ovulatory cycles in regularly menstruated kidney transplanted patients is similar to that of healthy women. Similar serum FSH, LH and PRL concentrations as well as increased levels of estrogens are observed in kidney graft recipients in comparison to healthy non-recipients. Increased levels of estrogens put that group of patients at risk of gynecological pathologies.
    Neuro endocrinology letters 01/2006; 27(1-2):198-202. · 0.93 Impact Factor
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    ABSTRACT: One of the effects of an improved general health state after successful kidney transplantation in women of reproductive age is recurrence of regular menstrual function. Sixty-three ovarian cycles in female kidney transplant recipient, aged from 18 to 44 years, at 1.5 to 15 years after transplantation, were compared with 50 cycles of healthy women. We monitored the menstrual cycle duration as well as follicle stimulation hormone (FSH), leutinizing hormone (LH), estradiol, progesterone, prolactin, creatinine, and testosterone serum concentrations as well as hematocrit and obtained sonographic observations of ovarian follicle growth and ovulation. Of the recipients, 68.1% had regular menstrual cycles. Ovulatory cycles were observed in 45% of patients. Estradiol concentration established in the first phase of the cycle was significantly higher among the transplanted group (mean value 226.86 +/- 97.45 pg/mL vs 140.00 +/- 61.00 in the controls). A significantly lower level of progesterone (15.05 +/- 17.34 ng/mL vs 30.79 +/- 18.48 ng/mL in the controls) and of testosterone were observed in kidney recipients. Other hormonal parameters did not differ significantly between the groups. Similar serum FSH, LH, and prolactin concentrations as well as increased levels of estrogens were observed in kidney transplant recipients compared with healthy nonrecipients. The rate of ovulatory cycles in regularly menstruated kidney graft recipients was similar to that of healthy women. Stabilization of graft function resulted in restoration of normal ovarian hormone metabolism and ovulatory cycles in female kidney transplanted recipients.
    Transplantation Proceedings 01/2006; 38(1):180-3. · 0.95 Impact Factor
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    ABSTRACT: Pregnancies in women after liver transplantation are considered high risk due to the greater rate of complications observed in immunosuppressed graft recipients. We report successful outcomes of four high-risk pregnancies in female liver transplant recipients on tacrolimus-based immunosuppression. The patients, aged 23 to 32 years, at the time of conception were 12 to 59 months from transplantation (mean 30 months). Preterm labor was the most important pregnancy complication observed in these patients. One episode of acute graft rejection was observed. A variable demand for tacrolimus was noted during pregnancy. Despite complications all four pregnancies were successful. The mean gestational age at delivery was 34.4 weeks. The birth weight of the newborns varied from 1410 to 3490 g (mean 2303 g) and the mean Apgar score was 8. No structural malformations or early complications were observed in the newborns. Excluding the patient with acute rejection, the remaining three cases showed all liver parameters to remain stable.
    Transplantation Proceedings 01/2006; 38(1):255-7. · 0.95 Impact Factor
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    ABSTRACT: A high rate of endometrial hyperplasia, an estrogen-dependent premalignant lesion of the endometrium, has been observed among female kidney allograft recipients. The aim of the study was to evaluate the incidence of endometrial abnormalities among renal transplanted women with abnormal uterine bleedings. A retrospective analysis compared 45 renal transplanted women who underwent dilatation and curettage for abnormal uterine bleeding between January 1999 and September 2004 with 90 consecutive, nontransplanted, control patients who underwent dilatation and curettage for the same reason in 2004. Thirty-one cases (69%) of endometrial hyperplasia and one case (2%) of endometrial cancer were detected among the renal allograft recipients. The majority of transplant patients (28 cases, 62%) developed endometrial hyperplasia without atypia successfully treated with progestagens. There were 29 cases (32%) of hyperplasia without atypia, 2 cases (1%) of atypical hyperplasia, and 4 cases (4%) of endometrial cancer in the control group. Renal transplanted women seem to have an extremely high risk of endometrial hyperplasia. The majority of cases may be successfully treated with progestagens. Immunocompromised renal graft recipients, however, show other risk factors for carcinogenesis. Thus, frequent clinical surveillance should be recommended in this group of patients, also because there is conflicting evidence with regard to the risk of progression to carcinoma among untreated patients.
    Transplantation Proceedings 01/2006; 38(1):177-9. · 0.95 Impact Factor
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    ABSTRACT: A higher risk of premature menopause and osteoporosis has been observed in female kidney-allograft recipients, providing particular indications for hormonal therapy. We have summarized our 10-year-experience with hormonal therapy in menopausal kidney transplant recipients. From 1995 to 2004, hormonal therapy was administered to 54 kidney transplant recipients. At onset of therapy the ages of the women ranged from 31 to 52 years, and the period from transplantation from 3 months to 13 years. The mean time on therapy was 4.2 years. All patients received transdermal estradiol (E(2)) in combination with oral progestin. Total regression of climacteric symptoms was reported in 75% of patients. After 3 months of the therapy follicle stimulating hormone (FSH) and E(2) levels normalized: FSH from 129 +/- 30.1 IU/L to 38.3 +/- 26.1 IU/L and E(2) from 18.5 +/- 5.8 pg/mL to 98.6 +/- 33.2 pg/mL. No significant change was noted in serum creatinine. Eleven patients developed abnormal uterine bleeding but none had premalignant or malignant lesions of the uterus on endometrial curettage. No incidence of breast cancer was noted during mean treatment period of 5.2 years. Seventeen patients discontinued therapy for medical indications: one for profound thrombophlebitis and 16 for significant deterioration of liver function. Twelve women made their own decision to discontinue therapy. Hormonal replacement therapy was effective with no negative impact either on graft function or sex organs among kidney transplant recipients. Liver parameter monitoring seemed to be essential for safe continuation of treatment.
    Transplantation Proceedings 01/2006; 38(1):184-7. · 0.95 Impact Factor