Pregnancy in Non-renal Solid Organ Transplant Recipients

Research questions

  • How many pregnancies are there amongst non-renal solid organ transplant recipients in the UK?
  • What are the outcomes for mother and infant?
  • What are the factors associated with poor pregnancy outcome?
  • Are there differences in outcome with different immunosuppressive regimens?

Background

Despite initial concerns about the advisability of pregnancy in solid-organ transplant recipients, there have now been reports of over 14,000 births to women with transplanted organs[1], predominantly among renal transplant recipients. Most studies are centre-based and retrospective[2]. Three voluntary registers have collected data at various times: the National Transplantation Pregnancy Register in the US (1991-present)[3], the UK Transplant Pregnancy Register (1994-2001)[2] and the European Dialysis and Transplant Association Registry (1960-1992)[4]. Increasing numbers of pregnancies are now occurring in recipients of non-renal solid organ transplants[1], however, the published information is insufficient to assess with confidence the outcomes associated with these pregnancies. These data are important in counselling and managing these women prior to and during pregnancy. The UK Transplant Register ceased to collect data in 2001 and there is currently no information available at a population level in the UK specifically relating to pregnancy. Immunosuppressive regimens are continually developing, and more information is needed about the intrauterine effects and neonatal consequences of immunosuppressive drugs. This project will collect information about pregnancy outcomes amongst current non-renal solid organ transplant recipients in the UK and assess the role of immunosuppressive regimens and other factors in the outcomes of women and their infants.

Case definition

All pregnant women with a transplanted solid organ, including heart, lung, liver, pancreas and small bowel. Isolated renal, corneal and bone marrow transplant recipients will be excluded.

Study size

The estimated incidence based on data from UK Transplant is 1 case per 29,000 pregnancies. We have therefore estimated that we will collect 120 cases of pregnancy in non-renal transplant recipients by active surveillance over a five year study period in the UK.

Download the Data Collection Form (DCF)

UKOSS Pregnancy in Non-renal Solid Organ Transplant Recipients Form

References

  1. a, b McKay DB, Josephson MA. Pregnancy in recipients of solid organs--effects on mother and child. N Engl J Med 2006; 354(12):1281-93.
  2. a, b Sibanda N, Briggs JD, Davison JM, Johnson RJ, Rudge CJ. Pregnancy following organ transplantation: a report from the UK Transplant Pregnancy Registry. (In Press) 2006.
  3. ^ Armenti VT, Radomski JS, Moritz MJ et al. Report from the national transplantation pregnancy registry (NTPR): outcomes of pregnancy after transplantation. Clin Transpl 2004; 103-14.
  4. ^ Rizzoni G, Ehrich JH, Broyer M et al. Successful pregnancies in women on renal replacement therapy: report from the EDTA Registry. Nephrol Dial Transplant 1992; 7(4):279-87.