Caring for the pregnant kidney transplant recipient

As fertility can be restored to normal soon after a kidney transplant, it is important for physicians caring for recipients to be able to inform the patient about the potential risks of pregnancy. Current opinion is that pregnancy can be successful if carried out under optimal circumstances, including stable allograft function for at least one yr post-transplant without rejection, good control of blood pressure, and appropriate adjustment of immunosuppression and other known teratogenic medications prior to conception. In planning for pregnancy, one should discuss pregnancy outcomes and risks to both the mother and fetus. During pregnancy, it is important to pay close attention to medical complications such as worsening of hypertension and development of preeclampsia; risk of infection, in particular of the urinary tract; and worsening anemia. Pregnant recipients should be managed in close conjunction with a high-risk obstetrician.