Pregnancy after living kidney donation, a systematic review of the available evidence, and a review of the current guidance
| Autor: | Maria Pippias, Laura Skinner, Marlies Noordzij, Anna Varberg Reisæter, Daniel Abramowicz, Vianda S. Stel, Kitty J. Jager |
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| Přispěvatelé: | Medical Informatics, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, ACS - Pulmonary hypertension & thrombosis |
| Rok vydání: | 2022 |
| Předmět: |
Male
pre-eclampsia DONORS kidney transplantation living donor Kidney Nephrectomy DISEASE Pregnancy Living Donors Humans Immunology and Allergy Pharmacology (medical) donor outcomes RISK OUTCOMES Transplantation CLINICAL-PRACTICE GUIDELINE HYPERTENSION Infant Newborn WOMEN CARE Pregnancy Complications PREECLAMPSIA RENAL ASSOCIATION Tissue and Organ Harvesting Female Human medicine donor nephrectomy |
| Zdroj: | American journal of transplantation American journal of transplantation, 22(10), 2360-2380. Wiley-Blackwell Pippias, M, Skinner, L, Noordzij, M, Reisæter, A V, Abramowicz, D, Stel, V S & Jager, K J 2022, ' Pregnancy after living kidney donation, a systematic review of the available evidence, and a review of the current guidance ', American Journal of Transplantation, vol. 22, no. 10, pp. 2360-2380 . https://doi.org/10.1111/ajt.17122 |
| ISSN: | 1600-6135 |
| DOI: | 10.1111/ajt.17122 |
| Popis: | Understanding and communicating the risk of pregnancy complications post-living kidney donation is imperative as the majority of living kidney donors (LKD) are women of childbearing age. We aimed to identify all original research articles examining complications in post-donation pregnancies and compared the quality and consistency of related guidelines. We searched Embase, MEDLINE, PubMed, society webpages, and guideline registries for English-language publications published up until December 18, 2020. Ninety-three articles were screened from which 16 studies were identified, with a total of 1399 post-donation pregnancies. The outcome of interest, post-donation pregnancy complications, was not calculable, and only a narrative synthesis of the evidence was possible. The absolute risk of pre-eclampsia increased from similar to 1%-3% pre-donation (lower than the general population) to similar to 4%-10% post-donation (comparable to the general population). The risks of adverse fetal and neonatal outcomes were no different between post-donation and pre-donation pregnancies. Guidelines and consensus statements were consistent in stating the need to inform LKDs of their post-donation pregnancy risk, however, the depth and scope of this guidance were variable. While the absolute risk of pregnancy complications remains low post-donation, a concerted effort is required to better identify and individualize risk in these women, such that consent to donation is truly informed. |
| Databáze: | OpenAIRE |
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