INVESTIGATION OF COGNITIVE AND PHYSICAL DEVELOPMENTAL ABILITIES OF YOUNG CHILDREN EXPOSED TO TACROLIMUS AND CYCLOSPORINE IN UTERO

Abstract

Kidney transplant recipients must take immunosuppressive medications to prevent the rejection of their transplanted kidney. If female transplant recipients become pregnant, however, very limited data are available about the effects of these medications on their exposed offspring. This study specifically reviews two of the most commonly used immunosuppressive medications prescribed to transplant recipients, cyclosporine and tacrolimus, and evaluates physical and cognitive development of the recipients' children who were exposed to these medications in utero. Participants in this study (n = 71) were female kidney transplant recipients who (a) voluntarily consented to be part of the National Transplantation Pregnancy Registry, (b) took cyclosporine or tacrolimus while pregnant, (c) had a child who is under the age of 6 years at the time of the study, and (d) were reachable via phone. Participants were asked standardized assessment questions related to their child's cognition and physical abilities from the Development Assessment of Young Children (DAYC). Standard scores from the assessment were recorded and analyzed to show that children exposed to cyclosporine or tacrolimus showed higher cognitive scores on the DAYC compared to the normative population. Children exposed to cyclosporine also showed higher physical scores compared to the normative population. Children exposed to tacrolimus did not show significant differences in physical development from the normative population. When cyclosporine or tacrolimus are required during pregnancy, these results help provide reassurance to parents and medical care providers about the cognitive and physical development of their offspring. Practical implications for school psychologists, limitations of this research, and directions for future research were discussed.