Aretrospective cohort study of pregnancy after kidney transplantation
10.3760/cma.j.cn421203-20210405-00120
- VernacularTitle:肾移植受者术后妊娠的回顾性队列研究
- Author:
Xiaobing FENG
1
;
Tingting XU
;
Turun SONG
;
Qiang ZHONG
;
Saifu YIN
;
Yu FAN
;
Zhongli HUANG
;
Tao LIN
Author Information
1. 四川大学华西医院泌尿外科 泌尿外科研究所 器官移植中心，成都 610041
- Keywords:
Kidney transplantation;
Pregnancy;
Immunosuppressant;
Allograft function
- From:
Chinese Journal of Organ Transplantation
2021;42(5):269-273
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety of pregnancy after kidney transplantation and summarize the optimal timing of pregnancy and the experience in the management during pregnancy and peripartum.Methods:A total of 25 kidney transplant recipients were pregnant during March 2013 to February 2020. A matched cohort of 75 general pregnant women wasincluded as control.Results:Twenty-five women successfully delivered healthy babies in the transplant group. The mean age at kidney transplantationwas (25.6 ±3.2) years old, and the mean interval between transplantation and conception was (54.0±23.1) months. 92% (23 / 25) of recipients had cesarean surgery and all infants were singletons.During pregnancy, the incidence of preeclampsia was significantly higher in the transplant group(20.0%VS. 1.3%, P=0.001)compared with matched control. Compared with pre-pregnancy, the serum creatinine levels of the recipients decreased in the second trimester( P<0.001)and increased in the third trimester( P=0.019), which was similar with the control group. In the third trimester, 40%(10/25)of recipients in the transplant group had proteinuria, which decreased to negative(5/10) or 1+ (4/10) within 6 months after delivery. No rejection occurred in all patients during pregnancy and 6 months after delivery. A higher dose of tacrolimus was needed to maintain the normal trough level after pregnancy, which returned to routine dose postpartum. Conclusions:Although the risk of pregnancy was higher in kidney transplant recipients than that in non-transplant women, the overall risk was acceptable. Strict screening of patients preparing for pregnancy, adjustment of immunosuppressive drugs, and multi-disciplinary collaboration are important for safe pregnancy and delivery.
