Pregnancy in renal transplant recipients.

Title
Pregnancy in renal transplant recipients: long-term effect on patient and graft survival. A single-center experience.
Source
Transplantation. 81(5):660-4, 2006 Mar 15.



BACKGROUND:

There are limited data on the effect of pregnancy on long-term renal allograft function. The aim of the study was to compare long-term graft and patient outcome between pregnant and nonpregnant women after renal transplantation.

Pregnancy in renal transplant recipients is considered high risk mainly because of the effect of the underlying condition on the pregnancy outcome. Rates of complications (perinatal mortality and morbidity), preterm delivery and intrauterine growth restriction (IUGR) are considerably higher in renal transplant recipients than in the general population.

While the introduction of immunosuppressive therapy has made kidney transplantation possible in women of childbearing age, thereby increasing their likelihood of pregnancy, it also contributes to a less favorable pregnancy outcome, even in comparison to patients with similar underlying renal conditions who are not receiving immunosuppressive therapy. Less is known about the effect of pregnancy on graft or patient survival, especially in the long term. Hyperfiltration and increased glomerular filtration rate during pregnancy may progressively damage the glomeruli of renal allografts, leading to loss of renal function due to glomerular sclerosis. Studies have shown that an estimated 11% of women with allografts develop new long-term medical problems after pregnancy, but it remains unclear whether these problems are time-related or directly precipitated by pregnancy.

CONCLUSION:

Pregnancy does not appear to have adverse effects on long-term graft or patient survival or kidney function in women after renal transplantation.