Impaired renal function after pregnancy in renal transplant recipients.
Twenty-two renal transplant recipients had 29 posttransplant pregnancies and 39 male transplant recipients became fathers to 65 children between 1971 and 1991. Of the deliveries of the female patients, 62% took place between the third and sixth year after transplantation. Seven patients had 2 pregnancies. Mean follow-up time after the first posttransplant pregnancy was 7.5 years. The patients survived the pregnancy well, but the increase in serum creatinine concentration from the prepregnancy level, registered 3 months and 1 year after delivery, was higher than in matched control patients without pregnancy at corresponding times after transplantation (the increase in serum creatinine was 47.7 and 61.2 mumol/L in the pregnant patients versus -2.7 and 5.4 mumol/L in the control patients, P < 0.0001 and P < 0.02, respectively). All pregnant and control patients were alive at the end of follow-up, but the long-term graft survival of those with a pregnancy was significantly (P < 0.005) worse than in the control patients. Ten-year graft survival was 69% in the pregnant versus 100% in the control patients. Although 80% of the neonates born to a mother with a transplanted kidney were below the mean for gestational age, the weight and length at birth were within normal limits and no severe intrauterine growth retardation was documented.
Salmela
K T
KT
Division of Transplantation, University of Helsinki, Finland.
Kyllönen
L E
LE
Holmberg
C
C
Grönhagen-Riska
C
C
D000328:Adult; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000009:adverse effects; D005260:Female; D005298:Fertility; D006085:Graft Survival; D006801:Humans; D007231:Infant, Newborn; D016030:Kidney Transplantation / Q000009:adverse effects / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010334:Paternity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011788:Quality of Life; D013997:Time Factors; D014511:Uremia / Q000150:complications* / Q000601:surgery*
D016572:Cyclosporine; D003404:Creatinine