It is recommended that mycophenolic acid (MPA) products be discontinued at least 6 wks prior to conceiving due to potential teratogenic effects and increase risk of miscarriages. The purpose of this study was to analyze pregnancy outcomes in kidney transplant recipients who conceived within 6 wks of discontinuing MPA. Data were collected by the National Transplantation Pregnancy Registry (NTPR) via questionnaires, telephone interviews, and medical records. There were 31 recipients who discontinued their MPA within 6 wks of conceiving 36 pregnancies (37 outcomes/1 set of twins), despite 84% of the pregnancies being reported as planned. Conceptions occurred between Sept. 1998 and Jan. 2015. The transplant to conception interval was 5.1±3.4 yrs. There were no rejections reported during pregnancy. Pregnancy outcomes included 6 miscarriages and 31 live births. The mean gestational age was 35.1±3.4 wks and 65% were premature (<37 wks); the mean birthweight was 2414±762 g and 52% were low birthweight (<2500 g). Two birth defects were reported in the newborn (5.4%): one infant had a multicystic kidney and another had a congenital pulmonary airway malformation. These do not fall within the pattern of birth defects seen with exposure to MPA products including microtia, facial and cardiac abnormalities.

Conclusions: In pregnancies reported to the NTPR, when MPA was discontinued within 6 wks of conception, outcomes including the rates of birth defects and miscarriages are similar to pregnancies not exposed to MPA. All transplant centers are encouraged to refer pregnancies to the NTPR.

CITATION INFORMATION: Sifontis N, Coscia L, Armenti D, Constantinescu S, Moritz M. What if Mycophenolic Acid Product Is Discontinued Less Than 6 Weeks Before Pregnancy? Am J Transplant. 2016;16 (suppl 3).

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