Current research
Solid Organ Transplantation and Pregnancy
(the fetal allograft)
Recipients of solid organ transplants who become pregnant represent an obstetrically high-risk population. Preconception planning and effective contraception tailored to the individual patient are critical in this group. Planned pregnancies improve both maternal and neonatal outcomes and provide a window of opportunity to mitigate risk and improve lifelong health. Optimal management of these pregnancies is not well defined. Common pregnancy complications after transplantation include hypertension, preterm birth, infection, and metabolic disease. Multidisciplinary preconception and prepartum management, and counseling decrease complications and benefit the maternal-neonatal dyad. We focus on understanding the fetal allograft in the setting of solid-organ transplantation and pregnancy.
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Two groups of pregnant kidney transplant recipients with preeclampsia and acute rejection were compared to each other to see what factors could differentiate their symptoms from each other. Patients with preeclampsia had higher proteinuria levels while patients with acute rejection had higher creatinine levels. The group with acute rejection experienced more graft loss and lower long term graft survival.
This report from the National Transplantation Pregnancy Registry (NTPR) compiles data on birth outcomes for 2000 pregnancies from transplant recipients.
Society for Maternal-Fetal Medicine's pre-pregnancy recommendations for transplant recipients include guidelines about monitoring renal function, medication use, mental health support and patients with hypertension.
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