Pregnancy after renal transplantation: severe intrauterine growth retardation during treatment with cyclosporin A

Pregnancy after renal transplantation: severe intrauterine growth retardation during treatment with cyclosporin ACyclosporin A is a fungal metabolite whose inhibitory effect is on T lymphocytes and in particular on cells mediating rejection of allografts.Evidence suggests that it may be more effective than conventional immuno- suppressive treatment in recipients of organ transplants.'Successful pregnancies have been reported in allograft recipients receiving cyclosporin daily from conception to delivery.2 3 We describe the clinical course of a pregnancy in a renal allograft recipient receiving cyclosporin A in which the fetus was growth retarded; we also review other such pregnancies.Case report A 31 year old woman underwent successful renal transplantation in 1983 for chronic renal failure secondary to malignant hypertension.Before developing renal failure she had had two normal normotensive pregnancies, which had resulted in two infants born at term weighing 2750 g and 2700 g.After developing severe hypertension and renal failure she conceived twice while receiving haemodialysis but aborted on both occasions.She subsequently conceived