Pregnancy after renal transplantation: an evaluation of the graft function

Objectives: To evaluate pregnancy outcomes and graft function in renal transplant recipients. Study design: Thirty-four pregnancies in 31 patients were evaluated. Graft dysfunction was defined as an increase of 0.3 mg/dL (215 mu mol/L) or more in serum creatinine (SCr) during pregnancy. Twenty-eight patients were also evaluated at one, six and twelve months after delivery to analyze the evolution of the graft function. Results: Fifteen patients experienced graft dysfunction during pregnancy, 10 related to preeclampsia, two related to rejection, one related to allograft obstruction and one related to urinary tract infection. One patient did not have an identified cause. In one patient, graft rejection ended in graft loss. The mean SCr level in the first trimester was 0.9 mg/dL (range: 0.5-2.1) among women who did not have graft dysfunction and 1.1 mg/dL (range: 0.5-1.9) among patients who had graft dysfunction (P = 0.66). The mean SCr level one year after delivery was 1.18 mg/dL in the first group and 1.21 mg/dL in the second group (P = 0.74). There was no difference in SCr level from the first trimester of pregnancy to one year after delivery in both groups evaluated (P = 0.35 and P = 0.13). Conclusions: Although graft dysfunction may occur during pregnancy, it seems to be temporary in the majority of the cases. It is important to emphasize that rejection is still a cause of graft loss during pregnancy. (C) 2010 Elsevier Ireland Ltd. All rights reserved.