Pregnancy After Kidney Transplantation: Outcomes, Tacrolimus Doses, and Trough Levels

Aktürk, Serkan; Çelebi, Zeynep Kendi; Erdogmus, Siyar; Kanmaz, Ahkam Göksel; Şengül, Şule; Keven, Kenan

doi:10.1016/j.transproceed.2015.04.041

Cited by 36 publications

(39 citation statements)

References 20 publications

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“…The most common pregnancy complications in these patients include infection, pre-eclampsia, premature delivery, premature membrane rupture, intrauterine growth retardation, LBW, gestational diabetes, and graft rejection. [1][2][3] In our study, all patients suffered from pre-eclampsia, which is related to premature delivery, intrauterine growth retardation, LBW, and neo-natal complications. Severe pre-eclampsia affected postnatal renal function, and two patients lost their grafts at 2 and 6 years after delivery, respectively; moreover, the incidence of pre-eclampsia was higher than reported in previous studies.…”

Section: Gestational Complications In Rt Patientsmentioning

confidence: 80%

“…Severe pre-eclampsia affected postnatal renal function, and two patients lost their grafts at 2 and 6 years after delivery, respectively; moreover, the incidence of pre-eclampsia was higher than reported in previous studies. [1][2][3][4][5][6] From the largest registers, the incidence of hypertension during pregnancy has varied between 58% and 72% in all kidney posttransplantation pregnancies. 4 Ghafari and Sanadgol 5 reported an incidence of 40%.…”

Section: Gestational Complications In Rt Patientsmentioning

confidence: 99%

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Pregnancy Outcomes After Renal Transplantation: A Retrospective Case Series

Jiang

Zhai

et al. 2020

Women's Health Reports

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Objective: To investigate the clinical characteristics and outcomes of pregnancies after renal transplantation (RT). Materials and Methods: A retrospective study was employed. Data of obstetric, transplantation, pregnancy outcomes, and maternal and neonatal complications from 2000 to 2017 were obtained from a single obstetrics center. Results: Eleven cases of pregnancies were included: the mean age at conception was 31.27 -3.44 (26-36, median 32) years and interval from RT to pregnancy was 51.18 -30.65 (25-132, median 38) months. The nine successful pregnancies (9/11) were all in women who maintained their immunosuppressive regimens. All infants were delivered by cesarean section for severe pre-eclampsia in eight cases and placental abruption in one case at a mean gestational age of 34.67 -1.41 (30-38) weeks and a median birth weight of 2374.56 -569.00 (1,325-3,070) g. Four of nine infants had low birth weight, and six of nine infants underwent premature delivery. The babies had no postpartum complications or congenital anomalies at follow-up period (12-180 months, mean 98.18 -54.73 months). One infant was transferred to the neonatal intensive care unit for neonatal asphyxia. Nine cases were uncomplicated at the first trimester, but developed severe pre-eclampsia after the second trimester. Two patients had allograft dysfunction from the second trimester and delivered at the third trimester, and then lost the allografts at 2 and 6 years postdelivery, respectively, whereas the other seven patients had well-functioning allografts at an average follow-up of 108 months. Two patients who decreased their immunosuppressive regimens and developed severe complications had second trimester therapeutic abortion and lost their allografts Conclusions: During pregnancy, RT patients exhibit risks for the mother, fetus, newborn, and allograft. Decreasing immunosuppressors leads to poor outcomes. With proper peritransplant and periconceptional counseling, these patients can have acceptable pregnancy outcomes.

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Section: Gestational Complications In Rt Patientsmentioning

confidence: 80%

Section: Gestational Complications In Rt Patientsmentioning

confidence: 99%

Pregnancy Outcomes After Renal Transplantation: A Retrospective Case Series

Jiang

Zhai

et al. 2020

Women's Health Reports

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“…Our patient's tacrolimus level was 5.2–11.4 ng/ml during her pregnancy and although erratic, she did not require an increased dose to maintain optimal plasma levels nor did she develop gestational diabetes or hypertension. For the best perinatal outcomes to be achieved, stable graft function is required, and according to the American Society of Transplantation, 1 year is the minimum recommended time between undergoing transplantation and trying to conceive to allow graft function to stabilise and immunosuppression to be reduced to maintenance levels …”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary care ensures successful pregnancy following intestinal transplantation: a case report

Blackwell

Holdaway

Hogan

et al. 2016

BJOG

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“…Adequate 'trough' levels need to be maintained. In general, immunosuppressive drugs need to be increased in pregnancy and tapered off in the postpartum period [22,23].…”

Section: About the Authormentioning

confidence: 99%

Uterus Transplant: Does It Have Legs?

Hegde¹

2017

J Obstet Gynecol India

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Pregnancy After Kidney Transplantation: Outcomes, Tacrolimus Doses, and Trough Levels

Cited by 36 publications

References 20 publications

Pregnancy Outcomes After Renal Transplantation: A Retrospective Case Series

Pregnancy Outcomes After Renal Transplantation: A Retrospective Case Series

Multidisciplinary care ensures successful pregnancy following intestinal transplantation: a case report

Uterus Transplant: Does It Have Legs?

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