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)

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, Professor 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 > School of Cardiovascular & Metabolic Health; 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