Hypothalamic–pituitary–gonadal axis function after successful kidney transplantation in men and women

• Published in: Human reproduction (Oxford) Vol. 19; no. 4; pp. 867 - 873
• Main Authors: Tauchmanovà, Libuse, Carrano, Rosa, Sabbatini, Massimo, De Rosa, Michele, Orio, Francesco, Palomba, Stefano, Cascella, Teresa, Lombardi, Gaetano, Federico, Stefano, Colao, Annamaria
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2004; Oxford Publishing Limited (England)
• Subjects: Adult; amenorrhea/hyperprolactinaemia/normogonadotrophic hypogonadism/premature ovarian failure/renal transplant; Biological and medical sciences; Case-Control Studies; Embryology: invertebrates and vertebrates. Teratology; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Gonads - physiopathology; Humans; Hypothalamo-Hypophyseal System - physiopathology; Kidney Transplantation - adverse effects; Luteinizing Hormone - blood; Male; Menstruation Disturbances - etiology; Ovary - diagnostic imaging; Postoperative Period; Primary Ovarian Insufficiency - etiology; Prostate - diagnostic imaging; Testis - diagnostic imaging; Testosterone - blood; Treatment Outcome; Ultrasonography; amenorrhea/hyperprolactinaemia/normogonadotrophic hypogonadism/premature ovarian failure/renal transplant; Human; Endocrine gland; Central nervous system; Transplantation; Hypothalamus; Kidney; Encephalon; Vertebrata; Mammalia; Urinary system; Female; Pituitary gland
• ISSN: 0268-1161; 1460-2350; 1460-2350
• DOI: 10.1093/humrep/deh192

BACKGROUND: Renal transplantation (RT) is the most common solid organ transplant procedure. Several studies have reported on gonadal function in male and female RT recipients with controversial results. METHODS: Forty consecutive patients (20 male, 20 female) with a fully functioning allograft (serum creatinine 0.8–1.3 mg/dl) for at least 15 months after RT were included in the study. Their ages ranged from 23 to 44 years (median 38) and their post‐RT follow‐up lasted 15–86 months (median 23). FSH, LH, prolactin, 17‐β‐estradiol, testosterone, androstenedione and dehydroepiandrostrone were determined in all patients and compared with a group of 80 healthy subjects. Pelvic ultrasonography was performed in all participants. RESULTS: Testosterone was below the normal range in 70% of male patients and within the lowest third in the remainder; a lack of LH increase indicated an inhibition of the reproductive axis. Male testosterone values were negatively influenced by calcineurine inhibitors treatment (P < 0.005), but positively influenced by a better graft function (P < 0.0001). Testicular and prostate volumes were reduced with respect to controls, with the latter related to circulating testosterone levels. Ten of the women (50%) had menstrual cycle disorders after RT, three being affected by transient, and three by persistent, amenorrhea. Another two patients had had transient polymenorrhea. In four women (20%), a premature ovarian failure was diagnosed. No relationship was found between female reproductive function and age, graft function or duration of the post‐transplant period. Prolactin was lower in patients on calcineurin inhibitors (P < 0.01). CONCLUSIONS: Abnormalities of the reproductive system were frequent after successful RT in both genders.