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Pregnancy does not adversely affect renal transplant function.

A V Crowe1, R Rustom, C Gradden

  • 1Renal Unit and Renal Transplant Unit, Royal Liverpool University Hospital and The Liverpool Womens' Hospital, Liverpool, UK. avcrowe@aol.com.uk

QJM : Monthly Journal of the Association of Physicians
|November 5, 1999
PubMed
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Pregnancy after kidney transplantation is common, with stable renal function observed. However, increased proteinuria during pregnancy typically resolves postpartum, necessitating pre-conception health assessments for optimal outcomes.

Area of Science:

  • Nephrology
  • Obstetrics
  • Transplant Surgery

Background:

  • Women with functioning kidney transplants often regain fertility, with significant improvements in renal function, endocrine status, and libido post-transplantation.
  • Approximately 1 in 50 women of childbearing age become pregnant after renal transplantation.
  • Concerns exist regarding hemodynamic changes during pregnancy potentially impacting graft function.

Purpose of the Study:

  • To examine obstetric data and renal parameters in women with functioning kidney transplants throughout pregnancy and postpartum.
  • To identify key parameters for optimizing obstetric outcomes and long-term graft survival in pregnant transplant recipients.

Main Methods:

  • Retrospective analysis of obstetric data and renal function parameters.

Related Experiment Videos

  • Inclusion of 29 patients and 33 pregnancies.
  • Monitoring of serum creatinine, creatinine clearance, and proteinuria.

    • Main Results:

    • Mean serum creatinine and creatinine clearance remained stable during pregnancy and one year postpartum.
    • Proteinuria significantly increased from 0.45 g/24 h at conception to 1.11 g/24 h at delivery (p<0.05).
    • Proteinuria resolved to baseline levels by 3 months postpartum.

    Conclusions:

    • Pregnancy in kidney transplant recipients is feasible with generally stable renal function.
    • Transient increases in proteinuria during pregnancy are common but typically reversible.
    • Pre-conception screening is crucial, including serum creatinine <150 micromol/l, proteinuria <1 g/day, absence of chronic allograft rejection, controlled blood pressure (140/90), and stable immunosuppression.