Abstract: FR-PO1149
Pregnancy After Kidney Transplantation: Thirty-Three Years of Data Collection from the Transplant Pregnancy Registry International
Session Information
- Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Constantinescu, Serban, Gift of Life Institute, Philadelphia, Pennsylvania, United States
- Coscia, Lisa, Gift of Life Institute, Philadelphia, Pennsylvania, United States
- Kliniewski, Dorothy, Gift of Life Institute, Philadelphia, Pennsylvania, United States
- Rao, Swati, Gift of Life Institute, Philadelphia, Pennsylvania, United States
- Moritz, Michael J., Gift of Life Institute, Philadelphia, Pennsylvania, United States
Background
The purpose of this study was to examine pregnancy outcomes among kidney transplant recipients (KTRs) reporting post-transplant pregnancies to the Transplant Pregnancy Registry International (TPRI).
Methods
We queried the TPRI database for KTRs reporting post-transplant pregnancies from registry inception in 1991 through 2024. Data were collected through questionnaires, telephone interviews, and medical record review.
Results
A total of 1,471 KTRs reported 2,659 pregnancies resulting in 2,754 outcomes, including multiple births. Maternal and neonatal outcomes are summarized in Table 1. Treated hypertension was reported in 48% of pregnancies, and preeclampsia occurred in 30%. Acute and/or chronic rejection during pregnancy was reported in 3% of recipients, while graft loss within 2 years of pregnancy occurred in 5.5%. Over time, exposure to mycophenolic acid products was reported in 8% of pregnancies across the cohort.
Among pregnancy outcomes, 74% resulted in live births, 52% were preterm and 42% had low birth weight (LBW; <2500 g). Long-term follow-up of 1,813 children born to KTRs found that 76% had normal growth and developmental outcomes.
Conclusion
Most pregnancies in KTRs resulted in successful maternal and neonatal outcomes, with 74% resulting in live births. Pregnancies in KTRs are high risk, with substantial rates of hypertension and preeclampsia. Despite the high incidence of prematurity and LBW, most children were reported to be healthy and developing appropriately on long-term follow-up. Planned pregnancies allow optimization of allograft function, management of comorbidities, and adjustment of immunosuppressive therapy prior to conception, particularly avoidance of fetal exposure to teratogenic mycophenolic acid products. We encourage the transplant community to report pregnancies to the TPRI.
Acknowledgment
Major funding for the TPRI is provided by the Transplant Foundation. An additional educational grant was received from Veloxis Pharmaceuticals, Inc.