Resident International Grant Blood transfusion Other conditions ). Tacrolimus is a macrolide obtained from Streptomyces, and is widely used as an immunosuppressant in transplant medicine. Skin diseases such as neurodermatitis are another indication; this will be discussed elsewhere (see Chapter 2.17). Certain advantages and disadvantages of tacrolimus in pregnancy are discussed compared to cyclosporine: rejection and hypertension are less common with tacrolimus, and the necessary dosage of prednisolone is lower. On the other hand, gestational diabetes occurs more often, as does transient hyperkalemia and transient reduction of kidney function in the newborn. Jain (1997) even reported on a newborn with anuria which lasted 36 hours. As with other immunosuppressant drugs, pre-eclampsia, prematurity, low birth weight, and cesarian births were seen at greater incidence.
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