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Contemporary Kidney Transplantation pp 1–18Cite as

Pregnancy After Kidney Transplantation

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Part of the book series: Organ and Tissue Transplantation ((OTT))

Abstract

Successful pregnancy after kidney transplantation has been reported worldwide since the 1960s and much of the clinical guidance regarding post-transplant pregnancy is derived from the experience in kidney recipients. This chapter includes a review of the relevant literature plus data from the National Transplantation Pregnancy Registry (NTPR) regarding pregnancy, maternal and newborn outcomes in this population and clinical management guidelines for the care of kidney transplant recipients before, during, and after pregnancy. Fertility is often restored soon after successful kidney transplantation; therefore, appropriate contraception and pregnancy counselling should be key components of pre- and post-transplant care. Conception planning is strongly recommended. If the recipient’s immunosuppressive regimen includes a mycophenolic acid (MPA) product, modifying the medication regimen prior to conception should be seriously considered as exposure confers substantial risks to the fetus. Close monitoring of the recipient, the transplant function, and her medications should continue throughout the pregnancy and postpartum. Post-transplant pregnancies are high-risk and warrant close collaboration among multiple disciplines to provide the best possible outcome for mother, her graft, and child.

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Acknowledgments

The NTPR acknowledges the cooperation of transplant recipients and the healthcare professionals of over 250 transplant centers in North America who have contributed their time and information to the NTPR. The NTPR is supported by grants from Astellas Pharma US, Inc., Pfizer Inc., and Bristol-Myers Squibb Company.

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Authors and Affiliations

  1. National Transplantation Pregnancy Registry (NTPR), Gift of Life Institute, 401 N. 3rd Street, Philadelphia, PA, 19123, USA

    Lisa A. Coscia, Dawn Armenti, Serban Constantinescu & Michael J. Moritz

  2. Kidney Transplant Program, Section of Nephrology, Hypertension and Kidney Transplantation, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA

    Serban Constantinescu

  3. Transplant Services, Lehigh Valley Health Network, 1250 S. Cedar Crest Blvd. Suite 210, Allentown, PA, USA

    Michael J. Moritz

  4. University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Michael J. Moritz

Authors
  1. Lisa A. Coscia
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  2. Dawn Armenti
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  3. Serban Constantinescu
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  4. Michael J. Moritz
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Corresponding author

Correspondence to Lisa A. Coscia .

Editor information

Editors and Affiliations

  1. Sidney Kimmel Medical College, Thomas Jefferson University Hospital Transplant Surgery, Philadelphia, Pennsylvania, USA

    Carlo Gerardo B. Ramirez

  2. Department of Medicine, Thomas Jefferson University Hospital Division of Nephrology, Philadelphia, Pennsylvania, USA

    Jerry McCauley

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In Memoriam

This manuscript is dedicated to Vincent T. Armenti, MD, PhD (1952–2014), the founding principal investigator of the NTPR. His guidance and leadership allowed the NTPR to flourish and provide countless transplant recipients with scientific information on which to base their family planning decisions.

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Coscia, L.A., Armenti, D., Constantinescu, S., Moritz, M.J. (2017). Pregnancy After Kidney Transplantation. In: Ramirez, C., McCauley, J. (eds) Contemporary Kidney Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-14779-6_29-1

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  • DOI: https://doi.org/10.1007/978-3-319-14779-6_29-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14779-6

  • Online ISBN: 978-3-319-14779-6

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