Pregnancy in sensitized kidney transplant recipients: a single-center experience.
We aimed to examine the clinical outcomes of sensitized pregnant kidney transplant recipients.



A retrospective cohort study of female patients who received kidney transplant at Montefiore transplant center between June 1, 2009 through December 31, 2014 and had a documented pregnancy in our system.



We found that 11 women had pregnancies during this period with a median age of 36 yr (range 22, 39). Pregnancies occurred at a median of 3.1 yr (1.1, 8.7) after transplantation. Pre-pregnancy patients' median serum creatinine levels and spot urine protein/creatinine ratio were 1.1 mg/dL (1.1, 2.1) and 0.55 g/d (0, 1.2), respectively. Eight patients were sensitized with panel reactive antibody (PRA) levels > 0% and three had PRA of 0%. The sensitized group had a higher incidence of adverse pregnancy outcomes; one stillbirth and two second trimester miscarriage. During a median follow-up of 2.3 yr (1.2, 4) after delivery, three high PRA patients (37%) developed antibody-mediated rejection that led to graft loss.



We observed an increased risk of rejection, graft loss, and adverse pregnancy outcomes in sensitized kidney recipients.
Montefiore - Einstein Center for Transplantation, Albert Einstein College of Medicine, Bronx, NY, USA.|Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY, USA.
Maria
M
Ajaimy
Montefiore - Einstein Center for Transplantation, Albert Einstein College of Medicine, Bronx, NY, USA.|Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY, USA.
Michelle
M
Lubetzky
Montefiore - Einstein Center for Transplantation, Albert Einstein College of Medicine, Bronx, NY, USA.
Timothy
T
Jones
Montefiore - Einstein Center for Transplantation, Albert Einstein College of Medicine, Bronx, NY, USA.|Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY, USA.
Layla
L
Kamal
Transplant Immunology Laboratory, Albert Einstein College of Medicine, Bronx, NY, USA.
Adriana
A
Colovai
Montefiore - Einstein Center for Transplantation, Albert Einstein College of Medicine, Bronx, NY, USA.|Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY, USA.
Graciela
G
de Boccardo
Montefiore - Einstein Center for Transplantation, Albert Einstein College of Medicine, Bronx, NY, USA.|Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY, USA.
Enver
E
Akalin
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000276:immunology; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009518:New York / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D066027:Transplant Recipients; D055815:Young Adult
D006680:HLA Antigens
fetal outcomes; kidney transplant; pregnancy; rejection