Renal transplantationOutcomeOutcome of Pregnancy in Renal Allograft Recipients: SIUT Experience
Section snippets
Patients and methods
From November 1985 to November 2005, a total of 348 female patients received renal allografts at our center. After excluding unmarried, divorced, those who had not completed 1 year posttransplant, or expired during first transplant year, and also those who had not yet delivered, there were 73 females of reproductive age. Parameters studied were immunosuppressive agents, episodes of rejection and antirejection treatment, presence of hypertension prior to pregnancy, new-onset hypertension,
Results
There were 47 pregnancies observed in 31 patients. Twenty-four patients were prescribed immunosuppression with CyA, AZA, Pred, except one on FK, MMF and Pred, and 7 were on two drugs: 5 received cyclosporine (CyA) and prednisolone (Pred) 2 azathioprine (AZA) and Pred due to CyA being discontinued at 17 and 36 months. Three patients had vascular rejections during the first posttransplant week, requiring ATG in two and OKT3 in one. None of the patients had acute rejection during pregnancy.
Median
Discussion
Many factors affect long-term graft survival, including HLA matching, renal ischemic injury, rejection episodes, hypertension, donor age and gender, as well as hyperlipidemia.6, 7 Pregnancy, as reported earlier, does not affect graft survival in the long term,2, 3, 4, 5 but the risk of graft dysfunction and poor pregnancy outcome both increase with baseline serum creatinine values at time of conception. Those women who have serum creatinine >1.75 mg/dL have reportedly shown further
References (10)
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Cited by (23)
Immunosuppressive therapy in SLE
2021, Lahita’s Systemic Lupus ErythematosusPregnancy after heart and lung transplantation
2014, Best Practice and Research: Clinical Obstetrics and GynaecologyCitation Excerpt :Secondary to an increase in circulation plasma volume and alterations in renal blood flow, CNI trough levels generally decrease during the first trimester, necessitating dosing adjustments. Of note, renal function per se is not negatively affected by pregnancy if kidney function (including renal allograft function) previously was stable [63]. As such, the normal increase in glomerular filtration rate still occurs in pregnant women, including those with renal transplants.
Pregnancy after kidney transplantation: A single-center experience and review of the literature
2014, Transplantation ProceedingsCitation Excerpt :The other early conception took place 10 months after KT, and the pregnancy successfully resulted in the birth of a healthy child at 38 weeks. Similarly to registry data and data from other small centers, our results show a rate of live births >70%, with 68% of healthy newborns [6,7]. Neonatal deaths and congenital anomalies among pregnancies reported by our center were infrequent (5.8%).
Pregnancy outcomes in kidney transplant recipients: A systematic review and meta-analysis
2011, American Journal of TransplantationCyclosporine and psoriasis: 2008 National Psoriasis Foundation<sup>*</sup> Consensus Conference
2010, Journal of the American Academy of DermatologyCitation Excerpt :Of 52 pregnancies in patients with renal transplantation, preterm delivery occurred in 20 (38.4%), and 16 (29.6%) newborns were small for gestational age.92 Premature birth and low birth weight have been reported in other series examining pregnancy outcome in patients with renal transplantation.93,94 Prematurity and low birth weight have also been reported in pregnancies after liver transplantation.95
Pregnancy after transplantation
2008, Transplantation ReviewsCitation Excerpt :This same recommendation applies to Myfortic (Novartis Pharmaceuticals Corp., East Hanover, New Jersey) (mycophenolic acid) usage. Of the many articles published on the topic of pregnancy after transplantation, many originate from outside the United States and include single cases, transplant centers, country and registry reports [60-75]. As previously mentioned, the AST organized a consensus conference on reproduction and transplantation, with a subsequent publication [47].