{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:19:42Z","timestamp":1780100382425,"version":"3.54.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,27]],"date-time":"2021-02-27T00:00:00Z","timestamp":1614384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The use of mycophenolic acid (MPA) in women during pregnancy causes an increase in miscarriages and birth defects with a typical embryopathy profile. Although epidemiological data does not suggest a greater risk among the offspring of male kidney transplant recipients, the European Medicines Agency and The Spanish Agency of Medicines and Medical Devices introduced the recommendation of using contraceptive methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a national retrospective study in 15 Spanish Kidney Transplant Centers to evaluate the frequency of miscarriages and birth defects between the offspring from male kidney transplants recipients. We included 151 males who had fathered 239 offspring, 225 under MPA and 14 without MPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results of our study showed an incidence of miscarriages in the MPA group of 9.8%, and of birth defects of 4%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed an incidence of miscarriages between the offspring fathered by kidney transplant males under MPA lower than the general population. The incidence of birth defects was similar to the incidence described in other studies and the fact that we did not find the typical embryopathy profile makes it difficult to associate them to the use of MPA. Because of that, we urge the European and Spanish Agencies to reconsider their recommendations for males.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14256","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T06:36:08Z","timestamp":1613630168000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Paternal safety of the use of mycophenolic acid in kidney transplant recipients. Results of the EMVARON study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5335-0555","authenticated-orcid":false,"given":"Paloma L.","family":"Martin\u2010Moreno","sequence":"first","affiliation":[{"name":"Nephrology Department Cl\u00ednica Universidad de Navarra Navarra Institute for Health Research (IdiSNA)  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana I.","family":"S\u00e1nchez\u2010Fructuoso","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Cl\u00ednico Universitario San Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Auxiliadora","family":"Mazuecos","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Puerta del Mar  C\u00e1diz Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Mir","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital del Mar  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Lopez\u2010Lopez","sequence":"additional","affiliation":[{"name":"Nephrology Department Instituto Maim\u00f3nides de Investigaci\u00f3n Biom\u00e9dica de C\u00f3rdoba (IMIBIC) Hospital Universitario Reina Sof\u00eda  C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Gonz\u00e1lez\u2010Rinne","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Universitario de Canarias Instituto de Tecnolog\u00edas Biom\u00e9dicas (ITB)\u2010Universidad de La Laguna  Tenerife Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Coca","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Cl\u00ednico Universitario de Valladolid  Valladolid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosal\u00eda","family":"Valero","sequence":"additional","affiliation":[{"name":"Nephrology Department H.U. Marqu\u00e9s de Valdecilla IDIVAL Universidad de Cantabria  Santander Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Ventura Galiano","sequence":"additional","affiliation":[{"name":"Kidney Transplant Unit Hospital Universitari i Polit\u00e9cnic La Fe  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Ridao","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Universitario Central de Asturias  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor G.","family":"Toapanta\u2010Gaibor","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Vall d'Hebron  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Fern\u00e1ndez\u2010Tagarro","sequence":"additional","affiliation":[{"name":"Nephrology Department Complejo Hospitalario Universitario Insular Materno\u2010Infantil  Las Palmas Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonidas","family":"Cruzado\u2010Vega","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital General Universitario de Elche  Elche Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"P\u00e9rez\u2010Mir","sequence":"additional","affiliation":[{"name":"Kidney Transplant Unit Nephrology Department Hospital Universitari Germans Trias i Pujol Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Universitario La Paz  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03686.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004352"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2013.01.003"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002903"},{"key":"e_1_2_9_6_1","first-page":"CD007746","article-title":"Mycophenolic acid versus azathioprine as primary immunosuppression for kidney transplant recipients","volume":"12","author":"Wagner M","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2016.09.014"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.7182\/pit2013636"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13159"},{"key":"e_1_2_9_10_1","unstructured":"European Medicines Agency (EMA).https:\/\/www.ema.europa.eu\/en\/news\/ema\u2010recommends\u2010additional\u2010measures\u2010prevent\u2010use\u2010mycophenolate\u2010pregnancy"},{"key":"e_1_2_9_11_1","unstructured":"Agencia Espa\u00f1ola de Medicamentos y Productos Sanitarios (AEMPS).https:\/\/www.aemps.gob.es\/informa\/notasinformativas\/medicamentosusohumano\u20103\/seguridad\u20101\/2015\/ni\u2010muh_fv_09\u2010micofenolato_y_micofenolato_sodico\/"},{"key":"e_1_2_9_12_1","unstructured":"ConstantinescuS CosciaL ArmentiDA MoritzMJ.Are there risks to fathering pregnancies after solid organ\u00a0transplantation?Presented at The 26th Congress of the\u00a0Transplantation\u00a0Society August 2016. 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