Kidney-Pancreas Transplant Survival after Pregnancy
1Medicine, University of Virginia Heath System, Charlottesville, VA, 2Transplant Pregnancy Registry International, Philadelphia, PA, 3Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, 4Surgery, Lehigh Valley Health Network, Allentown, PA
Meeting: 2020 American Transplant Congress
Abstract number: 403
Keywords: Kidney/pancreas transplantation, Pregnancy, Quality of life
Session Information
Session Name: Pancreas and Islet: All Topics I
Session Type: Oral Abstract Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:45pm
Presentation Time: 4:27pm-4:39pm
Location: Virtual
*Purpose: This study compared transplant survival after pregnancy in type 1 diabetic recipients (n=103) who received either kidney-pancreas (KP, n=61) or kidney alone (KA, n=42).
*Methods: Data were collected by the Transplant Pregnancy Registry International via questionnaires, phone interviews and medical record reviews. Kaplan Meier and Cox proportional hazard analyses were conducted for recipients and each graft (K, P in KP, and KA).
*Results: Outcomes are listed in the tables.
| Kidney Alone | Kidney-Pancreas | P-value | ||
| Recipients/Pregnancy/Outcomes | 42/63/64 | 61/107/114 | ||
| Caucasian | 66.7% | 82.0% | NS | |
| Age at Transplant (yrs) | 28.8±3.8 | 28.8±3.5 | NS | |
| Transplant-to-Conception Interval (yrs) | 3.0±2.2 | 4.0±2.9 | NS | |
| Acute Rejection During pregnancy | 0 | 4.8% | NS | |
| Drug treated hypertension | 54% | 53.3% | NS | |
| Preeclampsia | 37.2% | 36.8% | NS |
| Kidney Alone | Kidney-Pancreas | p-value | |
| Live births | 65.6% (n=42) | 68.4% (n=78) | NS |
| Mean gestational age (wks) | 33.9±3.3 | 34±3.3 | NS |
| Preterm (<37 wks) | 76.2% | 74.3% | NS |
| Mean birthweight (g) | 2423±842 | 2127±744 | 0.05 |
| Cesarean section | 83.3% | 70.4% | NS |
Pregnancy outcomes in KA and KP were similar, with a high rate of prematurity and Cesarean section, and a trend towards higher mean birthweight in KA vs. KP. Survival analyses showed no differences for KA vs. KP patient survival (p=0.98). The median patient survival (KA 22 yrs vs. KP 24.8 yrs, NS), K survival (KA 15.6 yrs vs. KP 17.6 yrs, NS), and P survival (16.4 yrs) were excellent and similar in both cohorts. There was a higher hazard ratio (HR) for K loss when there was a higher serum creatinine before pregnancy. For both P and K, unplanned pregnancy and rejection during pregnancy increased HR for graft loss.
*Conclusions: KP or KA recipients with pregnancy post-transplant have excellent patient and graft survival with high likelihood of successful pregnancy. The incidence of rejection during pregnancy is low, but associated with a higher risk of graft loss. Recipients of child bearing age should be counselled regarding potential for pregnancy as unplanned pregnancies increase risk of graft loss.
To cite this abstract in AMA style:
Rao S, Coscia L, Constantinescu S, Moritz MJ. Kidney-Pancreas Transplant Survival after Pregnancy [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-pancreas-transplant-survival-after-pregnancy/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress