Skip to main content
SpringerLink
Log in

Transplant and Pregnancy

  • Chapter
  • First Online:
Kidney Transplant Management

  • 967 Accesses

Abstract

Following renal transplantation, women of childbearing age may experience a return of fertility, and thus both pregnancy and contraception become an important part of the management of female kidney transplant recipients. In light of higher maternal and fetal risks during pregnancy, it is imperative to optimize allograft function and to modify immunosuppression prior to conception in renal transplant recipients. The following chapter will discuss conception planning, pregnancy outcomes, and medical management of the pregnant transplant recipient, highlighting the importance of a multidisciplinary approach to care.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Watnick S. Pregnancy and contraceptive counseling of women with chronic kidney disease and kidney transplants. Adv Chronic Kidney Dis. 2007;14(2):126–31.

    Article  Google Scholar 

  2. Hou S. Pregnancy in renal transplant recipients. Adv Chronic Kidney Dis. 2013;20(3):253–9.

    Article  Google Scholar 

  3. Pietrzak B, et al. Function of the ovaries in female kidney transplant recipients. Transplant Proc. 2006;38(1):180–3.

    Article  CAS  Google Scholar 

  4. Gill JS, et al. The pregnancy rate and live birth rate in kidney transplant recipients. Am J Transplant. 2009;9(7):1541–9.

    Article  CAS  Google Scholar 

  5. Hou S. Pregnancy in renal transplant recipients. Adv Ren Replace Ther. 2003;10(1):40–7.

    Article  Google Scholar 

  6. Saha MT, et al. Time course of serum prolactin and sex hormones following successful renal transplantation. Nephron. 2002;92(3):735–7.

    Article  CAS  Google Scholar 

  7. Zuber J, et al. Sirolimus may reduce fertility in male renal transplant recipients. Am J Transplant. 2008;8(7):1471–9.

    Article  CAS  Google Scholar 

  8. Baker RJ, et al. Renal association clinical practice guideline in post-operative care in the kidney transplant recipient. BMC Nephrol. 2017;18(1):174.

    Article  Google Scholar 

  9. Transplantation, E.E.G.o.R. European best practice guidelines for renal transplantation. Section IV: Long-term management of the transplant recipient. IV.10. Pregnancy in renal transplant recipients. Nephrol Dial Transplant. 2002;17(Suppl 4):50–5.

    Google Scholar 

  10. Armenti VT, et al. Pregnancy after transplantation. Transplant Rev (Orlando). 2008;22(4):223–40.

    Article  Google Scholar 

  11. Josephson MA, McKay DB. Pregnancy and kidney transplantation. Semin Nephrol. 2011;31(1):100–10.

    Article  Google Scholar 

  12. Shah S, Verma P. Overview of pregnancy in renal transplant patients. Int J Nephrol. 2016;2016:4539342.

    Article  Google Scholar 

  13. Centers for Disease, C. and Prevention. U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm Rep. 2010;59(RR-4):1–86.

    Google Scholar 

  14. Deshpande NA, et al. Pregnancy after solid organ transplantation: a guide for obstetric management. Rev Obstet Gynecol. 2013;6(3–4):116–25.

    PubMed  PubMed Central  Google Scholar 

  15. Hou S. Pregnancy in chronic renal insufficiency and end-stage renal disease. Am J Kidney Dis. 1999;33(2):235–52.

    Article  CAS  Google Scholar 

  16. Bramham K. Pregnancy in renal transplant recipients and donors. Semin Nephrol. 2017;37(4):370–7.

    Article  Google Scholar 

  17. Clowse ME, et al. A national study of the complications of lupus in pregnancy. Am J Obstet Gynecol. 2008;199(2):127.e1–6.

    Article  Google Scholar 

  18. Webster P, et al. Pregnancy in chronic kidney disease and kidney transplantation. Kidney Int. 2017;91(5):1047–56.

    Article  Google Scholar 

  19. Fakhouri F, et al. Pregnancy-associated hemolytic uremic syndrome revisited in the era of complement gene mutations. J Am Soc Nephrol. 2010;21(5):859–67.

    Article  CAS  Google Scholar 

  20. Armenti VT, et al. Report from the National Transplantation Pregnancy Registry: outcomes of pregnancy after transplantation. Clin Transpl. 2006:57–70.

    Google Scholar 

  21. Deshpande NA, et al. Pregnancy outcomes in kidney transplant recipients: a systematic review and meta-analysis. Am J Transplant. 2011;11(11):2388–404.

    Article  CAS  Google Scholar 

  22. Gorgulu N, et al. Does pregnancy increase graft loss in female renal allograft recipients? Clin Exp Nephrol. 2010;14(3):244–7.

    Article  Google Scholar 

  23. Davison JM. Towards long-term graft survival in renal transplantation: pregnancy. Nephrol Dial Transplant. 1995;10(Suppl 1):85–9.

    Article  Google Scholar 

  24. Sturgiss SN, Davison JM. Effect of pregnancy on long-term function of renal allografts. Am J Kidney Dis. 1992;19(2):167–72.

    Article  CAS  Google Scholar 

  25. Josephson MA, McKay DB. Considerations in the medical management of pregnancy in transplant recipients. Adv Chronic Kidney Dis. 2007;14(2):156–67.

    Article  Google Scholar 

  26. Henderson JT, et al. Low-dose aspirin for the prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force. 2014: Rockville (MD). Ann Intern Med. 2014;160(10):695–703.

    Article  Google Scholar 

  27. McKay DB, Josephson MA. Pregnancy in recipients of solid organs–effects on mother and child. N Engl J Med. 2006;354(12):1281–93.

    Article  CAS  Google Scholar 

  28. Flechner SM, et al. The presence of cyclosporine in body tissues and fluids during pregnancy. Am J Kidney Dis. 1985;5(1):60–3.

    Article  CAS  Google Scholar 

  29. Jain A, et al. Pregnancy after liver transplantation under tacrolimus. Transplantation. 1997;64(4):559–65.

    Article  CAS  Google Scholar 

  30. Armenti VT, et al. Immunosuppression in pregnancy: choices for infant and maternal health. Drugs. 2002;62(16):2361–75.

    Article  CAS  Google Scholar 

  31. Armenti VT, et al. Variables affecting birthweight and graft survival in 197 pregnancies in cyclosporine-treated female kidney transplant recipients. Transplantation. 1995;59(4):476–9.

    Article  CAS  Google Scholar 

  32. Moritz MJ, et al. Mycophenolate and pregnancy: teratology principles and National Transplantation Pregnancy Registry Experience. Am J Transplant. 2017;17(2):581–2.

    Article  CAS  Google Scholar 

  33. Sifontis NM, et al. Pregnancy outcomes in solid organ transplant recipients with exposure to mycophenolate mofetil or sirolimus. Transplantation. 2006;82(12):1698–702.

    Article  CAS  Google Scholar 

  34. Kumar M, et al. Pregnancy outcomes following exposure to abatacept during pregnancy. Semin Arthritis Rheum. 2015;45(3):351–6.

    Article  CAS  Google Scholar 

  35. Chakravarty EF, et al. Pregnancy outcomes after maternal exposure to rituximab. Blood. 2011;117(5):1499–506.

    Article  CAS  Google Scholar 

  36. Podymow T, August P. New evidence in the management of chronic hypertension in pregnancy. Semin Nephrol. 2017;37(4):398–403.

    Article  Google Scholar 

  37. Davison JM. Pregnancy in renal allograft recipients: problems, prognosis and practicalities. Baillieres Clin Obstet Gynaecol. 1994;8(2):501–25.

    Article  CAS  Google Scholar 

  38. Constantinescu S, et al. Breast-feeding after transplantation. Best Pract Res Clin Obstet Gynaecol. 2014;28(8):1163–73.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA

    Catherine A. Moore

Authors
  1. Catherine A. Moore
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Catherine A. Moore .

Editor information

Editors and Affiliations

  1. Department of Medicine, Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Sandesh Parajuli

  2. Department of Medicine, Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Fahad Aziz

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Moore, C.A. (2019). Transplant and Pregnancy. In: Parajuli, S., Aziz, F. (eds) Kidney Transplant Management. Springer, Cham. https://doi.org/10.1007/978-3-030-00132-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-00132-2_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-00131-5

  • Online ISBN: 978-3-030-00132-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation