A multi-institutional study of renal outcomes and renal-related pregnancy outcomes in uterus transplant recipients

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F22%3A00083675" target="_blank" >RIV/00023001:_____/22:00083675 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/22:10445390 RIV/00216208:11130/22:10445390

Výsledek na webu

<a href="https://reader.elsevier.com/reader/sd/pii/S160061352300062X?token=F6D087E7D289E8FDB84AB79159AD736F6DD4AED209F27579598DFA0DF3174E4968E32078E79F8E82C1CA85EBBEEAA926&originRegion=eu-west-1&originCreation=20230306134937" target="_blank" >https://reader.elsevier.com/reader/sd/pii/S160061352300062X?token=F6D087E7D289E8FDB84AB79159AD736F6DD4AED209F27579598DFA0DF3174E4968E32078E79F8E82C1CA85EBBEEAA926&originRegion=eu-west-1&originCreation=20230306134937</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/ajt.17149" target="_blank" >10.1111/ajt.17149</a>

Jazyk výsledku

angličtina

Název v původním jazyce

A multi-institutional study of renal outcomes and renal-related pregnancy outcomes in uterus transplant recipients

Popis výsledku v původním jazyce

Uterus transplantation (UTx) is an effective treatment option for uterine factor infertility. However, the need for immunosuppression and congenital renal anomalies that coexist with uterine agenesis in about 30% of women with Mayer-Rokitansky-Kuster-Hauser syndrome create a risk for renal dysfunction. We therefore examined renal function trajectory and related pregnancy complications in an international cohort of 18 UTx recipients from September 2016-February 2020 who had at least one live birth. All UTx recipients had a diminution in their renal function that was apparent starting at 30 days posttransplant and in half the reduction in eGFR was at least 20%; the decrease in eGFR persisted into the early post-partum period. Half met criteria for Stage 1 acute kidney injury (AKI) as defined by the AKI Network criteria during their pregnancy. Overall, 28% of UTx recipients developed pre-eclampsia. eGFR was lower at embryo transfer and throughout pregnancy among those who developed pre-eclampsia, reaching statistical significance at week 16 of pregnancy. This effect was independent of tacrolimus levels. Mean eGFR remained significantly lower in the first 1-3 months after delivery. In the subgroup who reached 12 months of postpartum follow up and had a graft hysterectomy (n = 4), there was no longer a statistical difference in eGFR (pretransplant 106.7 ml/m +/- 17.7 vs. 12 mos postpartum 92.6 ml/m +/- 21.7, p = .13) but the number was small. Further study is required to delineate long term renal risks for UTx recipients, improve patient selection, and make decisions regarding a second pregnancy.

Název v anglickém jazyce

A multi-institutional study of renal outcomes and renal-related pregnancy outcomes in uterus transplant recipients

Popis výsledku anglicky

Uterus transplantation (UTx) is an effective treatment option for uterine factor infertility. However, the need for immunosuppression and congenital renal anomalies that coexist with uterine agenesis in about 30% of women with Mayer-Rokitansky-Kuster-Hauser syndrome create a risk for renal dysfunction. We therefore examined renal function trajectory and related pregnancy complications in an international cohort of 18 UTx recipients from September 2016-February 2020 who had at least one live birth. All UTx recipients had a diminution in their renal function that was apparent starting at 30 days posttransplant and in half the reduction in eGFR was at least 20%; the decrease in eGFR persisted into the early post-partum period. Half met criteria for Stage 1 acute kidney injury (AKI) as defined by the AKI Network criteria during their pregnancy. Overall, 28% of UTx recipients developed pre-eclampsia. eGFR was lower at embryo transfer and throughout pregnancy among those who developed pre-eclampsia, reaching statistical significance at week 16 of pregnancy. This effect was independent of tacrolimus levels. Mean eGFR remained significantly lower in the first 1-3 months after delivery. In the subgroup who reached 12 months of postpartum follow up and had a graft hysterectomy (n = 4), there was no longer a statistical difference in eGFR (pretransplant 106.7 ml/m +/- 17.7 vs. 12 mos postpartum 92.6 ml/m +/- 21.7, p = .13) but the number was small. Further study is required to delineate long term renal risks for UTx recipients, improve patient selection, and make decisions regarding a second pregnancy.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30213 - Transplantation

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2022

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

American journal of transplantation

ISSN

1600-6135

e-ISSN

1600-6143

Svazek periodika

22

Číslo periodika v rámci svazku

12

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

3101-3110

Kód UT WoS článku

000923882300013

EID výsledku v databázi Scopus

2-s2.0-85134546742