ABSTRACT
BACKGROUND: We reported pregnancy outcomes after kidney transplantation in a single transplant center. METHODS: We reviewed the perinatal outcomes of female kidney transplant patients of reproductive age (18-40 years) from 1987 to 2011. RESULTS: A total of 246 patients were reviewed. Of these, 43 women registered a pregnancy following kidney transplantation. The mean patient age was 31.3 ± 4.2 years (range 24-40). The mean transplant-conception interval was 35.9 ± 12.6 months (range 24-120); 9 patients had a cadaveric allograft. The human leukocyte antigen match was ≥3/6 for 34 patients. The rate of live births was 29/43 (67.4%), miscarriage 10/43 (23.2%), preterm delivery 7/29 (24.1%), preeclampsia 5/29 (17.2%), and intrauterine growth retardation 2/29 (6.9%). Overall, 3/29 patients (10.3%) received a blood transfusion during pregnancy due to persistent symptomatic anemia, despite iron replacement and erythropoietin therapy; 24 patients (82%) had a cesarean section delivery; 3 patients had kidney rejection during pregnancy, with 2 occurring during the 6th postpartum month. CONCLUSION: Pregnancy should be considered a high risk in renal transplant recipients, necessitating close follow-up.
Subject(s)
Kidney Transplantation , Pregnancy Outcome , Abortion, Spontaneous/epidemiology , Adult , Birth Weight , Blood Transfusion/statistics & numerical data , Cesarean Section/statistics & numerical data , Female , Fetal Growth Retardation/epidemiology , Gestational Age , Graft Rejection/epidemiology , Humans , Immunosuppression Therapy , Infant, Newborn , Kidney Failure, Chronic/etiology , Kidney Failure, Chronic/surgery , Live Birth/epidemiology , Parity , Pre-Eclampsia/epidemiology , Pregnancy , Pregnancy Complications/immunology , Pregnancy Outcome/epidemiology , Pregnancy, High-Risk , Premature Birth/epidemiology , Retrospective StudiesABSTRACT
BACKGROUND: The literature indicates few studies on kidney patients' perception of the donor kidney. In light of this fact, we decided to explore this issue with adult patients. METHODS: We carried out a phenomenological study with 40 adult kidney patients. RESULTS: In this study, three main themes became apparent: the savior, gratitude, and feelings of intense responsibility for the kidney. The patients' perception of the kidney as a savior was evident in statements where patients spoke of being "reborn" and of the kidney as "a distinct being." Their sense of gratitude was evident in their description of the kidney as "a gift of life," in their comments on their improved, "quality of life" and sense of leading a "normal life." Feelings of intense responsibility for the kidney were also present: "always on my mind," "precious being," "uncertainty," and "contract." This study's unique finding was recipients' desire to enter a contract with the transplanted kidney in order to prevent the risk of rejection. CONCLUSIONS: This study indicates that in addition to the physiological care of kidney patients' during the pre- and postoperative phases, there is also an important psychological component. This demonstrates that the success of a kidney transplant does not only depend on the physical care given to the patient but also on the emotional support provided by those around them. Accordingly, healthcare providers should support the patients' emotional needs in a number of ways as suggested in the discussion.
