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Review
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Korean J Med. 2006;71(1):164-164.
- Outcome of Pregnancy in Renal Transplant Recipients : 15 Year Experience at a Single Medical Center in Korea.
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Hyun Jung Seok, Joo Eun Baek, Tae Hee Kim, Won Seok Yang, Su-Kil Park
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- Outcome of Pregnancy in Renal Transplant Recipients : 15 Year Experience at a Single Medical Center in Korea.
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경상대학교 의과대학 내과학교실1, 경상대학교 의과대학 영상의학과 교실2
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- Abstract
- Pregnancies in renal transplant recipients involve some risk. The time interval from transplantation to conception is regarded as
one of the most important factors for successful pregnancies. To identify graft, fetal and maternal outcomes, we analyzed 519
females of childbearing age who underwent renal transplantation between 01/1991 and 12/2005 at Asan Medical Center, Seoul,
Korea. Seventy-five pregnancies occurred in 48 recipients (living:cadaveric donor=32:16). The ages at transplantation and
pregnancy were 27.9¡¾4.0 yrs(mean¡¾SD)(range, 18-47yrs) and 31.6¡¾4.1 yrs (25-48yrs), respectively. The outcomes were 50 live
births, 10 miscarriages, 12 terminations, 2 still births, and 1 ectopic pregnancy. The time interval from transplantation to
pregnancy was 40.7¡¾27 months(7-120months). Eleven(14.7%) pregnancies which happened within 1 year resulted in 7 live
births(gestational age(GA) 37.5¡¾1wks, birth weight 2769.3¡¾405.8g), 2 miscarriages and 2 terminations. In 50 live births, GA was
37.1¡¾2.1weeks(25.4-40.1wks, <37wks:19) and birth weight was 2,667¡¾468g(range, 936-3905g, <2500g:14). Recipients who
achieved successful outcomes(n=50) had undergone transplantation(26.8¡¾3.5yrs vs 30.0¡¾4.1yrs, p<0.01) and conception(30.6¡¾
3.6yrs vs 33.4¡¾4.4yrs, p<0.01) at younger age than those failed to have successful outcomes(n=25). Serum creatinine before
pregnancy, at 1st, 2nd, 3rd trimesters and 3 months after delivery were 1.12¡¾0.24mg/dl, 1.08¡¾0.24 mg/dl, 1.05¡¾0.24 mg/dl, and
1.33¡¾0.66 mg/dl, respectively(p<0.05). Median follow-up after transplantation and delivery was 102months(n=48, 29-163 months)
and 73months(n=75, 1-152months), respectively, and 6 out of 48 grafts were lost at 50months(5-80months) after delivery. One
baby who had exposed to mycophenolate mofetil for 1st 8weeks of gestation was complicated with tracheoesophageal fistula. In
conclusion
, pregnancies even within the first year after renal transplantation may be tolerable for both grafts and offspring. The
recipients carried out transplantation and conception at younger age had better pregnancy outcomes.
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