Pregnancy in sensitized kidney transplant recipients: a single-center experience

Maria Ajaimy, Michelle Lubetzky, Timothy Jones, Layla Kamal, Adriana Colovai, Graciela de Boccardo, Enver Akalin

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: We aimed to examine the clinical outcomes of sensitized pregnant kidney transplant recipients. Methods: A retrospective cohort study of female patients who received kidney transplant at Montefiore transplant center between June 1, 2009 through December 31, 2014 and had a documented pregnancy in our system. Results: We found that 11 women had pregnancies during this period with a median age of 36 yr (range 22, 39). Pregnancies occurred at a median of 3.1 yr (1.1, 8.7) after transplantation. Pre-pregnancy patients’ median serum creatinine levels and spot urine protein/creatinine ratio were 1.1 mg/dL (1.1, 2.1) and 0.55 g/d (0, 1.2), respectively. Eight patients were sensitized with panel reactive antibody (PRA) levels > 0% and three had PRA of 0%. The sensitized group had a higher incidence of adverse pregnancy outcomes; one stillbirth and two second trimester miscarriage. During a median follow-up of 2.3 yr (1.2, 4) after delivery, three high PRA patients (37%) developed antibody-mediated rejection that led to graft loss. Conclusions: We observed an increased risk of rejection, graft loss, and adverse pregnancy outcomes in sensitized kidney recipients.

Original languageEnglish (US)
Pages (from-to)791-795
Number of pages5
JournalClinical Transplantation
Volume30
Issue number7
DOIs
StatePublished - Jul 1 2016

Fingerprint

Kidney
Pregnancy
Antibodies
Pregnancy Outcome
Transplants
Creatinine
Stillbirth
Graft Rejection
Second Pregnancy Trimester
Spontaneous Abortion
Cohort Studies
Retrospective Studies
Transplantation
Urine
Transplant Recipients
Incidence
Serum
Proteins

Keywords

  • fetal outcomes
  • kidney transplant
  • pregnancy
  • rejection

ASJC Scopus subject areas

  • Transplantation

Cite this

Pregnancy in sensitized kidney transplant recipients : a single-center experience. / Ajaimy, Maria; Lubetzky, Michelle; Jones, Timothy; Kamal, Layla; Colovai, Adriana; de Boccardo, Graciela; Akalin, Enver.

In: Clinical Transplantation, Vol. 30, No. 7, 01.07.2016, p. 791-795.

Research output: Contribution to journalArticle

Ajaimy, Maria ; Lubetzky, Michelle ; Jones, Timothy ; Kamal, Layla ; Colovai, Adriana ; de Boccardo, Graciela ; Akalin, Enver. / Pregnancy in sensitized kidney transplant recipients : a single-center experience. In: Clinical Transplantation. 2016 ; Vol. 30, No. 7. pp. 791-795.
@article{ad1be417cfa54059bc8bdc9993fa60ef,
title = "Pregnancy in sensitized kidney transplant recipients: a single-center experience",
abstract = "Background: We aimed to examine the clinical outcomes of sensitized pregnant kidney transplant recipients. Methods: A retrospective cohort study of female patients who received kidney transplant at Montefiore transplant center between June 1, 2009 through December 31, 2014 and had a documented pregnancy in our system. Results: We found that 11 women had pregnancies during this period with a median age of 36 yr (range 22, 39). Pregnancies occurred at a median of 3.1 yr (1.1, 8.7) after transplantation. Pre-pregnancy patients’ median serum creatinine levels and spot urine protein/creatinine ratio were 1.1 mg/dL (1.1, 2.1) and 0.55 g/d (0, 1.2), respectively. Eight patients were sensitized with panel reactive antibody (PRA) levels > 0{\%} and three had PRA of 0{\%}. The sensitized group had a higher incidence of adverse pregnancy outcomes; one stillbirth and two second trimester miscarriage. During a median follow-up of 2.3 yr (1.2, 4) after delivery, three high PRA patients (37{\%}) developed antibody-mediated rejection that led to graft loss. Conclusions: We observed an increased risk of rejection, graft loss, and adverse pregnancy outcomes in sensitized kidney recipients.",
keywords = "fetal outcomes, kidney transplant, pregnancy, rejection",
author = "Maria Ajaimy and Michelle Lubetzky and Timothy Jones and Layla Kamal and Adriana Colovai and {de Boccardo}, Graciela and Enver Akalin",
year = "2016",
month = "7",
day = "1",
doi = "10.1111/ctr.12751",
language = "English (US)",
volume = "30",
pages = "791--795",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Pregnancy in sensitized kidney transplant recipients

T2 - a single-center experience

AU - Ajaimy, Maria

AU - Lubetzky, Michelle

AU - Jones, Timothy

AU - Kamal, Layla

AU - Colovai, Adriana

AU - de Boccardo, Graciela

AU - Akalin, Enver

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background: We aimed to examine the clinical outcomes of sensitized pregnant kidney transplant recipients. Methods: A retrospective cohort study of female patients who received kidney transplant at Montefiore transplant center between June 1, 2009 through December 31, 2014 and had a documented pregnancy in our system. Results: We found that 11 women had pregnancies during this period with a median age of 36 yr (range 22, 39). Pregnancies occurred at a median of 3.1 yr (1.1, 8.7) after transplantation. Pre-pregnancy patients’ median serum creatinine levels and spot urine protein/creatinine ratio were 1.1 mg/dL (1.1, 2.1) and 0.55 g/d (0, 1.2), respectively. Eight patients were sensitized with panel reactive antibody (PRA) levels > 0% and three had PRA of 0%. The sensitized group had a higher incidence of adverse pregnancy outcomes; one stillbirth and two second trimester miscarriage. During a median follow-up of 2.3 yr (1.2, 4) after delivery, three high PRA patients (37%) developed antibody-mediated rejection that led to graft loss. Conclusions: We observed an increased risk of rejection, graft loss, and adverse pregnancy outcomes in sensitized kidney recipients.

AB - Background: We aimed to examine the clinical outcomes of sensitized pregnant kidney transplant recipients. Methods: A retrospective cohort study of female patients who received kidney transplant at Montefiore transplant center between June 1, 2009 through December 31, 2014 and had a documented pregnancy in our system. Results: We found that 11 women had pregnancies during this period with a median age of 36 yr (range 22, 39). Pregnancies occurred at a median of 3.1 yr (1.1, 8.7) after transplantation. Pre-pregnancy patients’ median serum creatinine levels and spot urine protein/creatinine ratio were 1.1 mg/dL (1.1, 2.1) and 0.55 g/d (0, 1.2), respectively. Eight patients were sensitized with panel reactive antibody (PRA) levels > 0% and three had PRA of 0%. The sensitized group had a higher incidence of adverse pregnancy outcomes; one stillbirth and two second trimester miscarriage. During a median follow-up of 2.3 yr (1.2, 4) after delivery, three high PRA patients (37%) developed antibody-mediated rejection that led to graft loss. Conclusions: We observed an increased risk of rejection, graft loss, and adverse pregnancy outcomes in sensitized kidney recipients.

KW - fetal outcomes

KW - kidney transplant

KW - pregnancy

KW - rejection

UR - http://www.scopus.com/inward/record.url?scp=84978254376&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978254376&partnerID=8YFLogxK

U2 - 10.1111/ctr.12751

DO - 10.1111/ctr.12751

M3 - Article

C2 - 27101447

AN - SCOPUS:84978254376

VL - 30

SP - 791

EP - 795

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 7

ER -