Pregnancy in Renal Transplant Recipients

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Research questions

  • How many pregnancies are there amongst renal transplant recipients in the UK?
  • What are the immediate pregnancy 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]. Most studies are centre-based and retrospective[2]. Three voluntary registers have collected data at various times: the US National Transplantation Pregnancy Register (1991-present)[3], the UK Transplant Pregnancy Register (1994-2001)2 and the European Dialysis and Transplant Association Registry (1960-1992)[4]. Recent analysis of data from the UK Transplant Pregnancy Register[2] has identified high rates of preterm delivery (50%) and delivery by caesarean section (72%) in pregnant renal transplant recipients. Worse outcomes were associated with poorer pre-pregnancy graft function and drug-treated hypertension during pregnancy. This register, however, no longer collects information. 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 renal transplant recipients in the UK and assess the role of immunosuppressive regimens and other factors in the outcomes of women and their infants. This information is important to inform future management and counselling of these women.

Case definition

All pregnant women with a transplanted kidney, with or without other transplanted organs.

Study Size

The estimated incidence based on data from UK Transplant is 1 case per 10,000 pregnancies. We have therefore estimated that we will collect 140 cases of pregnancy in renal transplant recipients by active surveillance over a two year study period in the UK.

Download the Data Collection Form (DCF)

UKOSS Pregnancy in Renal Transplant Recipients Form

References

  1. ^ 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.

Updated: Tuesday, 07 July 2020 14:44 (v4)