Pregnancy after renal transplantation: an evaluation of the graft function

Aivazoglou, Laís Uyeda; Sass, Nelson; Silva, Hélio T.; Sato, Jussara Leiko; Medina-Pestana, J.O.; Oliveira, Leandro De

doi:10.1016/j.ejogrb.2010.11.020

Cited by 26 publications

(24 citation statements)

References 12 publications

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“…A reduction in renal function in transplant recipients may be multifactorial, including preeclampsia, drug-induced, obstruction, rejection, and infection related or a physiologic return to prepregnancy values. Although 41% of women experienced at least one episode of a .20% rise in SCr during pregnancy, it did not appear to influence pregnancy outcomes, a finding comparable with other reports (28). Similarly, nearly a third of women developed new-onset proteinuria during pregnancy that was not associated with preeclampsia.…”

Section: Discussionsupporting

confidence: 74%

Pregnancy in Renal Transplant Recipients

Bramham

Nelson‐Piercy

Gao

et al. 2013

Clinical Journal of the American Society of Nephrology

195

160

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SummaryBackground and objectives Most reports of pregnancy outcome in women with kidney transplants are singlecenter, retrospective, and include small numbers and few are compared with controls. The aim of this study was to collect information about pregnancy outcomes among all kidney transplant recipients in the United Kingdom, managed with current antenatal and nephrologic care, and to compare these data with a contemporaneous control group.Design, setting, participants, & measurements Pregnant women with a kidney transplant were identified through the UK Obstetric Surveillance System (UKOSS) between January 1, 2007 and December 31, 2009. Data on a comparison cohort were obtained from the UKOSS database, containing information on comparison women identified in previous studies. Outcomes were also compared with national data.Results There were 105 pregnancies identified in 101 recipients. Median prepregnancy creatinine was 118 mmol/ L. Preeclampsia developed in 24% compared with 4% of the comparison group. Median gestation at delivery was 36 weeks, with 52% of women delivering at ,37 weeks, significantly higher than the national rate of 8%. Twentyfour infants (24%) were small for gestational age (,10th centile). There were two (2%) cases of acute rejection. Potential predictive factors for poor pregnancy outcome included .1 previous kidney transplant (P=0.03), first trimester serum creatinine .125 mmol/L (P=0.001), and diastolic BP .90 mmHg in the second (P=0.002) and third trimesters (P=0.05).Conclusions Most pregnancies in the United Kingdom in women with kidney transplants are successful but rates of maternal and neonatal complications remain high.

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Section: Discussionsupporting

confidence: 74%

Pregnancy in Renal Transplant Recipients

Bramham

Nelson‐Piercy

Gao

et al. 2013

Clinical Journal of the American Society of Nephrology

195

160

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Section: Discussioncontrasting

confidence: 66%

“…The authors concluded that it is important to emphasize that rejection is still a cause of graft loss during pregnancy. However, the study did not emphasize the degree of sensitization and presence of DSA that we found to be an important risk factor for increased risk of rejection postpartum (10). The best source of data for rejection and graft loss in pregnant transplanted women in the U.S. comes from National Transplantation Pregnancy Registry (NTPR) in 2011, which is a voluntary registry and does not capture all pregnancies in women with a prior organ transplant.…”

Section: Discussionmentioning

confidence: 92%

Pregnancy in sensitized kidney transplant recipients: a single‐center experience

Ajaimy

Lubetzky

Jones

et al. 2016

Clinical Transplantation

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“…Several factors are involved in the onset of hypertension after renal transplantation: immunosuppressive therapy including corticosteroids and cyclosporine, graft function, the nature of the donor, obesity, alcohol, smoking, presence of a native kidney (increased production of renin) [ 15 ]. The diagnosis of preeclampsia can be difficult due to the frequency of hypertension and proteinuria in kidney transplanted patients [ 16 ]. Yidirim et al reported in their study that 15% of patients with worsening hypertension without preeclampsia [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy after renal transplantation: a retrospective study at the military hospital of Tunis from 1992 to 2011

et al. 2017

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IntroductionOur study objective was to analyze the optimum conditions for pregnancy in kidney transplanted women. For that, we conducted a retrospective study was from 1992 to April 2011 about 17 pregnancies in 12 kidney transplanted patients followed in the Department of Obstetrics and Gynecology and Organ Transplant Unit of the Military Hospital of Tunis.MethodsWe studied nephrological parameters and obstetric pathologies encountered during pregnancy and the potential impact of pregnancy on graft. Our main outcome measures were: time between renal transplantation and conception, birth of a living child, renal graft defect.ResultsThe mean age at the time of renal transplantation was 30.11 years. The average age at the time of conception is 34.23 years. The average time between renal transplantation and the occurrence of pregnancy was 46.94 months. More than 40% of pregnancies were not planned. Of the 17 pregnancies, 12 have advanced beyond the first trimester with 91.6% resulting in the birth of a living child. Toxemia was found in 60% of cases, low birth weight in 50%, preterm in 30% and intrauterine growth retardation in 20% of cases. Cesarean section was indicated in all cases. Graft survival was 90% with a mean of 6 years after delivery.ConclusionPregnancy in kidney transplanted patients is a high-risk pregnancy, but pregnancy does not appear to affect graft function through certain conditions.

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Pregnancy after renal transplantation: an evaluation of the graft function

Cited by 26 publications

References 12 publications

Pregnancy in Renal Transplant Recipients

Pregnancy in Renal Transplant Recipients

Pregnancy in sensitized kidney transplant recipients: a single‐center experience

Pregnancy after renal transplantation: a retrospective study at the military hospital of Tunis from 1992 to 2011

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