Document Detail


Considerations in the medical management of pregnancy in transplant recipients.
MedLine Citation:
PMID:  17395118     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pregnancy, although rare in the patient with end-stage renal disease, is not uncommon in the transplant recipient. Physicians taking care of transplant recipients must be able to inform patients about the potential risks of pregnancy in this setting. The patient and her partner must know that the risks associated with pregnancy increase with worsening kidney function and hypertension. Current consensus opinion is that pregnancy can be relatively safely undertaken by 1 year after transplant if the patient has had no rejections during the year, allograft function is adequate, there are no infections that could affect the fetus, the patient is not taking teratogenic medications, and immunosuppressive medication dosing is stable. Consideration must be given to immunosuppression during pregnancy both with respect to the specific agents as well as the level of dosing. None of the medications are FDA category A; all are B or higher. Part of planning for pregnancy should include an evaluation of immunosuppression medication and a plan to modify the regimen prior to conception if its use may be risky for the developing fetus. Rejection can occur during a kidney transplant, so maintaining adequate immunosuppression is important. Other issues that need to be managed when caring for a pregnant transplant patient include: potential for infection (urinary tract infections are very common), hypertension, and anemia. The type of delivery, posttransplant contraception, and breast-feeding also need to be addressed.
Authors:
Michelle A Josephson; Dianne B McKay
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Advances in chronic kidney disease     Volume:  14     ISSN:  1548-5595     ISO Abbreviation:  -     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-30     Completed Date:  2007-06-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101209214     Medline TA:  Adv Chronic Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  156-67     Citation Subset:  IM    
Affiliation:
University of Chicago Hospitals, Chicago, IL 60637, USA. mjosephs@medicine.bsd.uchicago.edu
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MeSH Terms
Descriptor/Qualifier:
Anemia / drug therapy,  etiology
Counseling
Erythropoietin, Recombinant / therapeutic use
Female
Graft Rejection / diagnosis,  prevention & control
Humans
Hypertension / complications,  prevention & control
Immunocompromised Host*
Immunosuppressive Agents / therapeutic use
Infection / diagnosis,  etiology,  transmission
Kidney Failure, Chronic / complications,  surgery*
Kidney Transplantation* / adverse effects
Patient Care Team
Preconception Care
Pregnancy
Pregnancy Complications / prevention & control*
Time Factors
Chemical
Reg. No./Substance:
0/Erythropoietin, Recombinant; 0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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