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Pregnancy outcomes after childhood kidney transplant

As a trainee in the 1980s, I remember caring for a preterm infant who was the result of what was said to be the UK's first successful pregnancy in a renal transplant recipient. Things have moved on, and transplanted women can now confidently expect to become mothers. But can we be as optimistic about girls transplanted while still children? A report based on the Australia and New Zealand Dialysis and Transplant Registry says we can (Wyld ML et al. JAMA Pediatr 2015. doi:10.1001/jamapediatrics.2014.3626) Using data on all renal transplants done in those countries between 1963 and 2012, the authors identified 101 pregnancies in 66 women transplanted as children (<18 years), and 626 pregnancies in 401 women transplanted as adults. They compared these groups and found no significant differences between them for a range of important outcomes: in both groups live birth rates were around 76%, and both groups had similarly high rates of pre-eclampsia (28%), preterm birth (c. 50%<37 weeks) and intra-uterine growth restriction. Similarly there was no difference in rates of deterioration of renal function after pregnancy. Gratifyingly, over the whole 5-decade era, pregnancy termination rates for child-transplanted women …

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