Session Time: 3:15pm-4:45pm
Presentation Time: 4:27pm-4:39pm
*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.
|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|
|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|
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 May 8, 2021.
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