Pregnancy after renal transplantation: critical analysis of the physiopathology aspects

Abstract

Most of the data on pregnancy in solid organ recipients is mentioned in kidney transplantation reports. This fact is correlated to the fertility rehabilitation and improvement in practically all patients due to the re-establishment of the endocrine and menstrual functions, which generally happens between 1 to 30 months after the transplant. The rejection incidence in these patients during pregnancy is of 9%, which is statistically and non significantly related to a non pregnant population of receptors. When present, rejection episodes have an important influence on the result of the pregnant woman due to the compromising of the renal function. In kidney transplant patients, the prematureness index oscillates between 45 to 65% regardless the immunosuppressive scheme adopted or the interval time between the transplant and pregnancy. Still, there is some difficulty to set whether the loss of the graft function is due to the pregnancy or to factors attributed at the time of transplant. Study performed on pregnancy case-control after renal transplant did not reveal any influence on the pregnancy on the graft function. It was based on multi-centric reports documented in the National Transplantation Pregnancy Registry (N.T.P.R.). Concluding, the transplant rehabilitates the IRCT bearer to the pregnancy. On the other hand, the after renal transplant gestation does not represent a restricting factor to the maintenance of the allograft function.