Impact of Pregnancy on GFR Decline and Kidney Histology in Kidney Transplant Recipients

Parenthood With Kidney Failure: Answering Questions Patients Ask About Pregnancy

“…69,78,79,98,115 Even in women with "good" graft function (serum creatinine <110 mmol/l), a proportion of women have decline in function antenatally and postpartum "stageshift," 69,79 ; however, further studies have not linked this GFR drop to excessive graft failure. 116 Late cessation of mycophenolic acid derivatives (<6 weeks prepregnancy) has been associated with increased risk of graft loss at 5 years, 117 possibly reflecting unplanned pregnancy. Acute rejection during pregnancy has been reported in 1% to 10% of pregnancies.…”

Acute kidney injury during pregnancy in kidney transplant recipients

“… 31 Postpregnancy transplant biopsies demonstrated an increase in vascular injury as compared to pre‐pregnancy biopsies, after adjusting for time, which could be related to high incidence of preeclampsia in this population. 32 A multidisciplinary approach should be employed to decide if a biopsy is necessary.…”

The Importance of Maintaining Reproductive Choices for Kidney Transplant Recipients

“…2 Exposure to fetal antigens and fluctuations in immunosuppressive drug levels can increase the potential for rejection of the allograft. 5,6 Based on a patient's individual circumstance, post-transplant pregnancy may represent an unacceptably high health risk for some including those with decreased allograft function and proteinuria. Pregnancy risks are even greater in patients with an additional nonkidney transplant or multiorgan (i.e., combined kidney pancreas) transplant.…”