Does pregnancy increase graft loss in female renal allograft recipients?

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Abstract
Although many transplanted women who were previously infertile can conceive during the posttransplant period, maternal and fetal complications are likely. We evaluated the effect of pregnancy after renal transplantation in this study. We retrospectively evaluated female renal transplant recipients who became pregnant. Age- and transplantation time-matched nonpregnant patients were used as a control group. We analyzed data regarding the demographic features of the pregnant patients, their serum creatinine levels before pregnancy, during pregnancy and during the postpartum period until now, immunosuppressive drugs, complications during pregnancy and fetal complications. In total 57 patients were included in this study. We divided the transplanted patients into two groups: 22 deliveries in 19 patients (delivery group) and 38 nonpregnant patients (control group). The mean follow-up durations and ages of transplantation were similar in the two groups. There was no significant difference in the mean serum creatinine values of the two groups (p = 0.42). Regarding immunosuppressive drugs, there was no significant difference between the two groups (p = 0.23). The frequencies of chronic hypertension, proteinuria, use of erythropoietin, and urinary tract infection were not statistically significantly different between the two groups (p = 0.31, 0.59, 0.36, 0.28, respectively). There were also no significant differences noted in graft and patient survival between the groups (p = 0.577). Female transplant recipients who have stable creatinine levels, insignificant proteinuria, and normal blood pressure or controlled hypertension may become pregnant, and they can have successful pregnancies. Their graft functions and survivals are not affected by gestation.

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