Pregnancy After Renal Transplant: Single Center Experience From the Middle East in Patients Using Different Calcineurin Inhibitors
| Autor: | Osama Gheith, Prasad Nair, Mohamed Abdelmonem, Torki Al-Otaibi, Yahya Makkeyah, Zakaria Zakaria, Tarek Said, Hassanen Aboatteya, Ahmed F Atta, Islam S Elsawi, Medhat A Halim, Ayman Maher Nagib |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Time Factors medicine.medical_treatment Calcineurin Inhibitors 030230 surgery Organ transplantation Tacrolimus Preeclampsia 03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors medicine Humans Caesarean section Transplantation business.industry Obstetrics Graft Survival Panel reactive antibody Pregnancy Outcome medicine.disease Kidney Transplantation Calcineurin Pregnancy Complications Low birth weight Treatment Outcome Kuwait Case-Control Studies Cyclosporine Drug Therapy Combination Female medicine.symptom Live birth business Live Birth Immunosuppressive Agents |
| Zdroj: | Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation. 17(Suppl 1) |
| ISSN: | 2146-8427 |
| Popis: | Objectives Pregnancy after kidney transplant has a high risk for maternal and fetal complications; however, it can be successful if patients are properly selected. Here, we studied outcomes and complications of pregnancies in kidney transplant recipients who received calcineurin inhibitor-based immunosuppression. Materials and methods In this case control study, we reviewed patients who became pregnant between 2004 and 2017. For this analysis, each pregnancy was considered an event. We divided pregnancies into 2 groups according to calcineurin inhibitor-based maintenance immunosuppression: group 1 (49 pregnancies) received cyclosporine, and group 2 (33 pregnancies) received tacrolimus. Patients also received steroids and azathioprine. Patients had regular antenatal follow-up at the Hamed Alessa Organ Transplant Center (Kuwait) and in the maternity hospital (monthly until month 7 and then weekly until delivery). Results Of 750 female kidney transplant recipients within childbearing potential, there were 82 pregnancies (10.9%) in 49 recipients (6.5%). Seventy-eight pregnancies were planned, and 4 pregnancies occurred while women were using contraception. There was 1 triple pregnancy, 5 double, and 76 single pregnancies. Two women had preeclampsia as maternal complication, 2 had uncontrolled hypertension, and 7 developed graft dysfunction. Forty-seven women (57.3%) had caesarean section, and the remaining had vaginal deliveries. Of 89 babies, 86 were viable (1 intrauterine fetal death and 2 abortions). Eight babies were delivered prematurely with low birth weight, and 2 needed incubators. Mean serum creatinine levels were 97.9 ± 24, 109 ± 38, 100 ± 39, 120 ± 46, and 115 ± 57 μmol/L at baseline, first, second, and third trimesters, and postpartum, respectively. Twelve patients showed high panel reactive antibodies but without donor-specific antibodies. Conclusions Posttransplant pregnancy can be successful in most renal allograft recipients, but the increased risk of fetal and maternal complications, including low birth weight, spontaneous abortus, and preeclampsia, should be considered. |
| Databáze: | OpenAIRE |
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