Pregnancy and Renal Transplantation: A Case Report of the Risk of Antibody Induction Against Partner Antigens

Cornella, C.; Riboni, Francesca; Praticò, L.; Conca, Raffaele; Fenoglio, Roberta; Lazzarich, Elisa; Surico, N; Paternoster, D.M.

doi:10.1016/j.transproceed.2009.06.233

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…Vaginal is proposed in 1st intention in these patients (Penn et al, 1980). Acute rejection is similar or even lower than in general population (Armenti et al, 1994;Davison 1995 ;Framarino di Malatétaita et al, 1993;Tanabe et al, 1997;Moritz 2002), in the absence of risk factors, which can explained anti-HLA antibodies made during and after the pregnancy (Cornella et al, 2009). We did not observe any case of acute rejection in our study.…”

Section: Discussionsupporting

confidence: 54%

Pregnancy in renal transplant recipients

Boubaker¹,

Hedri²,

Abderrahim³

et al. 2015

Int. J. Med. Med. Sci.

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Fertility is considerably affected in chronic renal insufficiency and periodic hemodialysis, and it is improved by renal transplantation. Transplanted patients recover from their renal failure state, and pregnancy occurred in 2% renal graft recipients who were fit to procreate. The aim of this study was to bring back the cases of pregnancies carried out in our renal patients who had transplantation surgery and to specify the possible complications of the foetus before and after the childbirth. It is a retrospective study with records of 20 years period (1986 to 2006) of 10 pregnancies which occurred in 7 renal transplant recipients in our Charles Nicole hospital department. Mean patient age was 33.8 years (29 to 43 years). Mean time between transplantation and the onset of pregnancy was 6.5 years (1 to 18 years). Before pregnancy, hypertension was observed in 1 case and proteinuria in other case. All our patients had creatininemia <1.50 mg/dl. Immunosuppressive treatment associated steroids and azathioprin in 3 cases, steroids and ciclosporin A in 2 cases and steroids, ciclosporin A and azathioprin in 2 cases. One patient developed diabetes. Maternal complications were rare, essentially hypertension in 2 cases, proteinuria in 1 case, ascension of creatininemia in 2 cases and hepatic cholestase in 2 cases. Prematurity was observed in 2 cases; it was related to premature rupture of membranous in 1 case and uterine contractions in cesarean patient in other case. The mean neonatal weight was 2950 g (2100 to 3500 g) with 4 small gestational age (< 2800 g). It was noted in 1 case of newborn, down's syndrome in a pregnant women who was 37 years. After a mean follow up of 7.4 years follow-up, mean cretininemia was 1.80 mg /dl (0.74-5.53 mg /dl). One patient showed chronic rejection. Immunosuppressive treatment seemed without adverse effects on fetus. The only case of chromosome abnormality appeared in a pregnant women who was more than 35 years old. The course of pregnancy after renal transplantation is generally uncomplicated without increased risk of graft loses. However, a normal arterial pressure, a stable renal function and absence of proteinuria were requested before allowing a pregnancy.

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Section: Discussionsupporting

confidence: 54%

Pregnancy in renal transplant recipients

Boubaker¹,

Hedri²,

Abderrahim³

et al. 2015

Int. J. Med. Med. Sci.

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“…The incidence of acute rejection is low as found by several investigations [14]. Generally, pregnancy does not seem to have any adverse eff ect on the long-term graft survival of renal allografts [15]. If there is a suspicion of acute rejection based on clinical signs and symptoms, it has to be confi rmed by ultrasound guided core biopsy.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy management of women with kidney transplantation

Kovács

Szabó

Jenei

et al. 2015

IMAS

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Abstract:Women with renal disease, besides many dysfunctions, face increasing infertility and high-risk pregnancy due to uremia and changes of the hormonal functions. After renal transplantation, sexual dysfunction improves, providing the possibility of successful pregnancy for women of childbearing age. However, kidney transplanted patients are high-risk pregnant patients with increased maternal and fetal risks, and the graft also may be compromised during pregnancy; most studies report on several successive deliveries due to multidisciplinary team management. In clinical practice, the graft is rarely aff ected during the period of gestation. Fetal development disorders are also rare although preterm delivery and intrauterine growth retardation are common. For now, several studies and clinical investigations proved that, under multidisciplinary control, kidney transplanted female patients are also possible to have safe pregnancy and successful delivery. There are confl icting data in the literature about the prevention of complications and the timing of pregnancy. Herein, we would like to present some experience of our centre. A total of 847 kidney transplantations have been performed between June 1993 and December 2013 with 163 childbearing aged females (18-45 years) in our center. We report on three kidney transplanted patients who have given birth to healthy newborns. In our practice, severe complications have not been observed.

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“…L'incidence des épisodes du rejet aigu est similaire à celle de la population générale des transplantés rénaux en particulier si la créatininémie est inférieure à 150µmol/l et la patiente est sous traitement immunosuppressur adapté [ 10 , 14 , 22 , 36 , 37 ] ou survient principalement en fin de grossesse. L'activation immunitaire aigue est inhabituelle mais peut survenir et elle est expliqué par la formation malgré l'immunosuppression, d'anticorps dirigés contre le partenaire ou le donneur [ 38 ]. De ce fait, une détection des anticorps anti-HLA doit être faite avant, pendant et après la grossesse pour ne pas passer à côté d'une activation immunitaire [ 38 ].…”

Section: Discussionunclassified

Grossesse et transplantation rénale: à propos de 10 cas

Boubaker¹,

Mahfoudhi²,

Abderrahim³

et al. 2015

Pan Afr Med J

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La grossesse chez les patientes transplantées rénales est à risque de complications maternelles mais surtout fœtales. Le risque de survenue de rejet aigue ou chronique inhérent à la grossesse est faible. L'objectif de notre étude était de rapporter les grossesses survenues chez nos transplantées rénales, leurs aspects évolutifs et une revue de la littérature. L’âge moyen des patientes au moment de la transplantation rénale était de 28,5 ans. Le traitement immunosuppresseur d'entretien a associé une corticothérapie, l'azathioprine et/ou la ciclosporine A. Le délai moyen entre la transplantation rénale et la découverte de la grossesse était de 6,5 ans. L’âge moyen au moment de la conception était de 33,8 ans. Il n'ya pas eu de modifications du traitement immunosuppresseur au cours de la grossesse. La créatininémie moyenne au cours de la grossesse était stable à 104,8 µmol/l avec une créatininémie supérieure à 150 µmol/l dans 2 cas. Les complications maternelles au cours de la grossesse étaient une hypertension artérielle gravidique dans 3 cas, une protéinurie dans 3 cas, une ascension de la créatininémie au 7ème mois dans 2 cas, une cholestase hépatique gravidique dans 2 cas et une hyperuricémie dans 4 cas. Une prématurité était observée dans 3 cas en rapport avec une rupture prématurée des membranes, des contractions utérines sur utérus cicatriciel et des signes de prééclampsie dans le troisième cas. Après l'accouchement, Une hypertension artérielle était observée chez 3 patientes. On n'a pas noté de rejet aigu chez nos patientes. La créatininémie moyenne était de 195,3 µmol/l (74- 553 µmol/l). Le développement statural et psychomoteur était normal pour 9 enfants. La bonne évolution des grossesses chez les patientes transplantées rénales une planification et un suivi régulier.

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Pregnancy and Renal Transplantation: A Case Report of the Risk of Antibody Induction Against Partner Antigens

Cited by 9 publications

References 13 publications

Pregnancy in renal transplant recipients

Pregnancy in renal transplant recipients

Pregnancy management of women with kidney transplantation

Grossesse et transplantation rénale: à propos de 10 cas

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