Obstetric and long-term kidney outcomes in renal transplant recipients: a 40 year single-centre study

Stoumpos, S., McNeill, S. H., Gorrie, M., Mark, P. B. , Brennand, J. E., Geddes, C. C. and Deighan, C. J. (2016) Obstetric and long-term kidney outcomes in renal transplant recipients: a 40 year single-centre study. Clinical Transplantation, 30(6), pp. 673-681. (doi:10.1111/ctr.12732) (PMID:26992458)

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Abstract

Female renal transplant recipients of childbearing age may ask what the outcomes are for pregnancy and whether pregnancy will affect graft function. We analyzed obstetric and transplant outcomes among renal transplant recipients in our center who have been pregnant between 1973 and 2013. A case−cohort study was performed identifying 83 pairs of pregnant and non-pregnant controls matched for sex, age, transplant vintage, and creatinine. There were 138 pregnancies reported from 89 renal transplant recipients. There were live births in 74% of pregnancies with high prevalence of prematurity (61%), low birth weight (52%), and pre-eclampsia (14%). Lower eGFR (OR 0.98; p = 0.05) and higher uPCR (OR 1.86; p = 0.02) at conception were independent predictors for poor composite obstetric outcome. Lower eGFR (OR 0.98; p = 0.04), higher uPCR (OR 1.50; p = 0.04), and live organ donation (OR 0.35; p = 0.02) were predictors of ≥20% loss of eGFR between immediately pre-pregnancy and one yr after delivery. There was no difference in eGFR at one, five, and 10 yr in pregnant women compared with non-pregnant controls and a pregnancy was not associated with poorer 10-yr transplant or 20-yr patient survival. Despite high rates of obstetric complications, most women had successful pregnancies with good long-term transplant function.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mark, Dr Patrick and Stoumpos, Dr Sokratis and Brennand, Dr Janet
Authors: Stoumpos, S., McNeill, S. H., Gorrie, M., Mark, P. B., Brennand, J. E., Geddes, C. C., and Deighan, C. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Clinical Transplantation
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0902-0063
ISSN (Online):1399-0012
Published Online:06 April 2016
Copyright Holders:Copyright © 2016 John Wiley and Sons
First Published:First published in Clinical Transplantation 30(6):673-681
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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