Pregnancy outcomes in kidney transplant recipients and their newborns
Burak Sayin1, Aydincan Akdur2, Berna Dogan2, Latife Atasoy Karakas3, Emre Karakaya2, Ebru H. Ayvazoglu Soy2, Mehmet Haberal2.
1Department of Nephrology, Baskent University, Ankara, Turkey; 2Department of General Surgery, Division of Transplantation, Baskent University, Ankara, Turkey; 3Department of Obstetrics and Gynecology, Baskent University, Ankara, Turkey
Introduction: Kidney transplantation is associated with improved reproductive function in female recipients compared to patients on dialysis. In our center, 15 kidney transplant recipient women gave birth after transplantation under close follow-up and regulation of immunosuppressive treatment prior to pregnancy. We aimed to describe the perspective of gestation and birth in female kidney transplant recipients in Başkent University in the last 10 years.
Materials & Methods: Fifteen female kidney transplant recipients who gave a birth between years 2012-2022 were included. Maternal and fetal complications are reported to be at higher rates in kidney transplant recipients. Cessation of mycophenolate mofetil/mycophenolate sodium and conversion to azathioprine and ongoing calcineurin inhibitors is the protocol of prior to planned pregnancy in our center. Patients were simultaneously were followed up in transplant outpatient clinic and obstetrics & gynecology (O&G) clinic with an average of 2 weeks period.
Results: Pregnant kidney transplant recipients had a mean age of 28.2 ± 3.4 years. Hypertension was the most common complication in the third trimester with a rate of 46.6% in our population. Although all the pregnant kidney transplant recipients gave a successful birth and no maternal complication has been experienced in our center, all the newborns had premature birth and low birth weight and small for gestational age infants. All the newborns have been discharged after an average duration of hospital stay of 14.6 ± 4.2 days.
Conclusion: Pregnancy after kidney transplantation is a period with potential risks for mother, newborn and the allograft. Planned gestation, regulation of immunosuppressive and other drugs, close follow-up with cooperation of O&G and transplantation unit is essential and showing excellent results in pregnant kidney transplant recipients and their newborns.
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