신장이식후 임신이 이식신의 예후와 임신의 결과에 미치는 영향

Abstract

Background: The number of pregnancies in renal transplant recipients has increased. Many studies have shown that pregnancy increases the risk of graft, fetal, and maternal complications but does not affect the long-term outcome of the graft. We assessed the incidence and effect of pregnancy after renal transplantation and examined graft, fetal, and maternal outcomes. Methods: Our study included 145 female recipients of child-bearing age (15∼45 years) in our center from January 1990 to December 2011. The subjects were divided into two groups: pregnancy (n=17) and control (n=128). The 26 pregnancies in the 17 recipients were categorized as live births (n=10) or no-live births (n=16). These were analyzed for evaluation of pregnancy outcomes, graft function, and long-term graft survival. Results: The pregnancy and control group had similar graft function and graft survival rates 5- and 10-year after renal transplantation. Outcomes of pregnancy were 10 live births, 8 therapeutic abortions, 7 spontaneous abortions, and 1 stillbirth. The mean serum creatinine levels of the pregnant recipients diminished during the first trimester (1.14±0.37 mg/dL) and increased slightly during the third trimester (1.18±0.37 mg/dL) to levels nearer the baseline (1.23±0.37 mg/dL). These ranges were stable. The mean time from transplantation to pregnancy was 20.73±3.57 months. Live birth rates were associated with the time from transplantation to pregnancy (71.78±37.75 months for live births and 19.38±12.71 months for no-live births, P=0.000). There were no significant differences in graft function, graft failure rates, and survival. Conclusions: Pregnancy does not appear to have an adverse effect on graft function and the long-term outcomes of renal transplantation. Recipients with stable renal function who want to become pregnant can have successful pregnancies.