Successful Pregnancies in Kidney Transplant Recipients: Experience of the National Kidney Transplant Program From Uruguay

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• 作者：S. Orihuela^a ; M. Nin^a ; ^b ; ^{mninvaez@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; S. San Romá ; n^b ; O. Noboa^b ; L. Curi^a ; R. Silvariñ ; o^b ; F. Gonzá ; lez-Martí ; nez^a ; ^b
• 刊名：Transplantation Proceedings
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：48
• 期：2
• 页码：643-645
• 全文大小：295 K

文摘

Renal transplantation increases the possibilities of pregnancy in women of reproductive age. The course of pregnancy was analyzed retrospectively in patients with kidney or kidney-pancreas transplant, surveying maternal-fetal or renal graft complications and the relation with pre-pregnancy renal function.

Methods

A cohort that includes all the kidney transplant recipients who went through pregnancy in Uruguay in a period of 28 years is described. Forty pregnancies in 32 patients were registered; the average time between the kidney transplant and the beginning of the gestation period was 47 months. From the total gestations, 10 abortions, 1 neonatal death, and 1 fetal demise were registered. From the remaining pregnancies, we highlight prematurity (18/29) and low birth weight (14/21). Twenty-nine in 30 pregnancies ended in cesarean section; in 8 of 30, pre-eclampsia diagnosis was performed. Acute rejection was diagnosed in 2 of 30 pregnancies, both undergoing their first post-transplant year.

Results

Two patients required dialysis throughout the pregnancy because of progress into severe renal insufficiency. Higher obstetric perinatal morbidity and renal function deterioration was related to lower pre-pregnancy glomerular filtration rate (GFR).

Conclusions

A successful pregnancy is possible in transplant recipients, yet there are risks of prematurity, low birth weight, and abortion. A lower GFR before pregnancy was associated with poorer maternal and perinatal results as shown in the different series.