Pregnancy after renal transplantation: report of 2 cases and review of the literature / 中华器官移植杂志

ABSTRACT

Objective To investigate the influence of pregnancy and delivery on maternal graft and newborns after renal transplantatior.Method Two cases of successful pregnancy and delivery after renal transplantation were retrospectively analyzed and the literatures were reviewed.Result The first recipient received the immunosuppressive treatment,which was based on the mycophenolate after renal transplantation.Three years after transplantation,the recipient had the requirement of pregnancy,but there was no pregnancy without contraception for over one year.On the next month after the myocphenolate-based immunosuppressive regimen changed to the purine-based,B ultrasound revealed follicular growth,ovulation and pregnancy.Caesarean section was performed at 37 gestational weeks and a body was delivered.The weight of the boy was 2 750 g,and the Apgar scores of the newborn were 10.The second recipient received triple immunosuppressive therapy (cyclosporin A + azathioprine + methylprednisolone),and got natural pregnancy 4 years after renal transplantation.The recipient was hospitalized due to the increased blood pressure and reduced fetal heart rate at 33 W+2 gestational weeks,and discharged after treatment.Caesarean section was performed at 38 W+1 gestational weeks,the weight of the boy was 3 000 g,and the Apgar scores of the newborn was 10.After follow-up for 8 years old,there was on abnormity of the function of the transplanted kidney and the growth of the newborns.Conclusion Successful pregnancy and delivery are possible in renal transplant recipients with normal renal function.Regulating the immunosuppressive regimen appropriately,and treating the complications of pregnancy effectively can obtained the satisfactory outcome of pregnancy.