title: Pregnancies in women receiving renal transplant for lupus nephritis: description of nine pregnancies and review of the literature.
abstract: BACKGROUND
  Few data are available on pregnancy in renal transplanted women for lupus nephritis (LN).
  
  
  METHODS
  Among 38 women with LN who received a renal transplant in our Unit, three had nine pregnancies. During the pregnancies, patients were followed by a multidisciplinary team including gynecologists and nephrologists.
  
  
  RESULTS
  Two patients received a living related and one a deceased kidney transplant. The immunosuppressive therapy consisted of steroids calcinurin inhibithors and mycophenolate mofetil. The last drug was substituted with azathioprine in prevision of pregnancy. All patients had normal renal function and urinalysis. In two patients some signs of immunological activity persisted after transplantation. Five pregnancies ended in miscarriage and four in live births. Two pregnancies were uneventful. Pre-eclampsia occurred in a hypertensive patient in two pregnancies that ended in preterm delivery in one case and in a small for gestation age in both cases. And finally, follow-up graft function and urinalysis continued to be normal in all patients.
  
  
  CONCLUSIONS
  After renal transplantation our LN women continue to have frequent miscarriages. The other pregnancies ended in live births and, with the exception of pre-eclampsia in a hypertensive patient, no renal or extra-renal complications occurred during or after pregnancy, even in cases with active immunological tests.
authors.affiliation: Department of Nephrology and Dialysis, Fondazione Ca' Granda IRCCS Ospedale Maggiore, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Campise
authors.affiliation: Department of Nephrology and Dialysis, Fondazione Ca' Granda IRCCS Ospedale Maggiore, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Giglio
authors.affiliation: Department of Obstetric and Gynecology, Fondazione Ca' Granda IRCCS Ospedale Maggiore, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Trespidi
authors.affiliation: Department of Nephrology and Dialysis, Fondazione Ca' Granda IRCCS Ospedale Maggiore, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Messa
authors.affiliation: Department of Nephrology and Dialysis, Fondazione Ca' Granda IRCCS Ospedale Maggiore, Milan, Italy gmoroni@policlinico.mi.it.
authors.forename: G
authors.initials: G
authors.lastname: Moroni
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000032:analysis; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000503:physiopathology*; D016030:Kidney Transplantation; D008181:Lupus Nephritis / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000503:physiopathology; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000209:etiology*; D011256:Pregnancy Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000974:Antibodies, Antinuclear; D000959:Antihypertensive Agents; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D001379:Azathioprine; D011241:Prednisone
keywords: Pregnancy; anti-DNA antibodies; renal lupus