Background: Renal transplantation (RTx) is the most common solid organ transplant procedure. Several studies have reported on puberty and gonadal function in female RTx recipients with controversial results.
Objective: We sought to describe puberty and gonadal function in adolescents after RTx before 16 years.
Methods: We reported retrospectively the clinical signs of puberty, growth, medication and graft function of 20 girls aged 19.63±4.21 years transplanted before 16 years old. Furthermore, hormonal and ultrasonographic characteristics were performed in these girls followed from 2014 to 2015 in Necker Hospital.
Results: The age of onset of puberty was 12.4±1.6 (1016) years and the age of menarche was 14.1±1.6 (1117.5) years. Final size was significantly delayed compared to the target size (154.2±3.1 vs 163.7±1.1 cm, P=0.0035). There was no significant correlation between age at telarche and age at RTx or with the corticosteroid dose. The patients with renal function below 60 ml/min/ 1.73 m2 had a slightly delayed menarche (14±2 years vs 12.5±0.5 years, P=0.29). Fifteen percents were amenorrheic, 21% spaniomenorrheic. The median FSH levels were 5.2±2.75 (2.896) IU/l. Three patients had a low AMH level (<1 ng/ml). All patients had an immunosuppressive therapy with a calcineurin inhibitor, an anti metabolite and corticosteroids.
Conclusion: Pubertal development was normal in female adolescents after RTx with age at menarche slightly higher than that reported in the general population. Although she appears to be broadly conserved ovarian function may be impaired, but the mechanisms are not elucidated.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology