Reproductive health in Irish female renal transplant recipients

Ir J Med Sci. 2012 Mar;181(1):59-63. doi: 10.1007/s11845-011-0767-4. Epub 2011 Oct 28.

Abstract

Objective: To report the pregnancy outcomes in Irish female renal transplant recipients on modern maintenance immunosuppression.

Methods: The Republic of Ireland transplant database was accessed to identify the patient cohort in question. All female renal transplant recipients whose transplantation was in Ireland before or during their reproductive years were included. A questionnaire was sent to the identified women. A chart review was performed for those women who reported a pregnancy following renal transplantation.

Results: Two hundred and ten women met the inclusion criteria. There was a response rate of 70% (n = 148). Eighteen women reported 29 pregnancies. The live birth rate was 76%. The mean gestation of the live births was 36.2 weeks with a mean birth weight of 3.0 kg. There were six cases of pre-eclampsia. Twin pregnancies and those entering pregnancy with a creatinine greater than 135 ┬Ámol/l had particularly complicated clinical courses. Four women had not conceived post transplant despite actively trying for over 1 year. Two women utilised assisted fertility methods (in vitro fertilisation), one of whom became pregnant.

Conclusions: A significant proportion of women who attempt to conceive following renal transplantation are successful, without the use of assisted fertility. Pregnancy in this setting warrants meticulous multidisciplinary care.

MeSH terms

  • Abortion, Spontaneous / etiology
  • Adult
  • Birth Weight
  • Female
  • Gestational Age
  • Humans
  • Immunosuppression Therapy / adverse effects
  • Immunosuppressive Agents / adverse effects*
  • Ireland
  • Kidney Transplantation* / adverse effects
  • Live Birth*
  • Pre-Eclampsia / etiology
  • Pregnancy
  • Pregnancy Rate*
  • Reproductive Techniques, Assisted
  • Tacrolimus / adverse effects*
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Tacrolimus