Pregnancy & Renal Transplantation

Pregnancy & Renal Transplantation
Presentation by:Alicia Notkin

Case Study:

A 30 year old female w/ ESRD, s/p LDRT from her mother 3 years prior, comes to clinic for f/u. She is fully compliant with her regimen of prednisone 5mg daily, tacro 3mg q12h, and MMF 1g q12h. Her renal function has been stable, with a Cr ~ 1.2 mg/dl and a negative UA. She wishes to become pregnant. How should she be advised & managed?


Outline

* Pregnancy in patients with chronic kidney disease
* Pregnancy in patients on dialysis
* Pregnancy in renal transplant patients
* Transplantation medications in pregnancy
* Recommendations
* Other issues: graft dysfunction in pregnancy, donor & pregnancy, male fertility

Pregnancy in patients with chronic kidney disease: patient considerations
Pregnancy in patients with chronic kidney disease: other patient considerations
Pregnancy in patients with chronic kidney disease: fetal outcomes
Pregnancy in patients on dialysis
Pregnancy in renal transplant patients: outcomes
Transplant medications: steroids
Transplant medications: cyclosporine
Transplant medications: tacrolimus
Transplant medications: sirolimus
Transplant medications: mycophenolate mofetil
Transplant medications: azathioprine
AST Consensus Conference on Reproductive Issues & Transplantation 2005
Recommendations: key points
Graft dysfunction in pregnancy
OK to biopsy??
Issues for donor & male recipient

References

Pregnancy & Renal Transplantation.ppt