Background. Mild elevation of blood pressure after unilateral nephrectomy may contribute to elevate gestational hypertension or preeclampsia in women donors. To date, impact of kidney donation on maternal and fetal outcomes had not been well established especially in Asian population.

Methods We included women kidney donors with childbearing age at the time of kidney donation between 1972 and 2014. Women with older than 45 years old were excluded. We gathered information about peri-gestational complications pregnancy experiences by using telephone poll and electrical medical record review. We compared predonation, post-donation and matched general pregnancy outcomes. General pregnancy outcomes were extracted from our delivery cohort consisted of women with a singleton pregnancy. Fetal outcome was defined as fetal death. Maternal outcomes included development of gestational hypertension, preeclampsia, and Cesarean section.

Results We finally included 225 kidney donors were included after exclusion of 35 donors without any experience of pregnancy. A total of 370 pregnancies from 186 mothers occurred before kidney donation. Fifty-six pregnancies from 39 mothers developed after kidney donation. Age at the time of delivery was older in women conceived after donation than those before donation (32.0 ± 3.8 vs 26.6 ± 4.0 years old, P <0.001). Women experienced pregnancy after donation had higher body mass index. However, they showed similar incidence of fetal death (1.4% vs 1,1%) than women with pre-donation pregnancy. However, they showed higher gestational hypertension development (5.4% vs. 2.7%), higher preeclampsia rate (3.6% vs 2.4%), and higher incidence of Cesarean section (40.4% vs 21.9%) compared with women with pre-donation pregnancy. However, adverse maternal risk of post-donation pregnancies was not different with that of matched general pregnancies.

Conclusion This study revealed women with postdonation pregnancies experienced similar fetal death with those with predonation pregnancies. Adverse maternal outcomes in pregnant women after kidney donation was higher than in those before kidney donation. However, the risk was similar to general non-donor pregnancies.

CITATION INFORMATION: Lee H., Yoo K., Yu M., Kim Y. Maternal and Fetal Outcomes in Living Kidney Donors in Korea Am J Transplant. 2017;17 (suppl 3).

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