Successful pregnancy in a recipient of an ABO-incompatible renal allograft

Nitesh N. Rao, Chris Wilkinson, Mark Morton, Greg D. Bennett, Graeme R. Russ, Patrick T. Coates, Shilpa Jesudason

Research output: Contribution to journalArticle

Abstract

Kidney transplantation restores fertility in patients with end-stage renal disease, with many successful pregnancies after kidney transplantation being reported. However, there are little data regarding pregnancy in women transplanted under modern-era desensitisation protocols that utilise rituximab, plasma exchange and intravenous immunoglobulin, including ABO-incompatible transplants. Pregnancies in ABO-incompatible recipients can pose new challenges from an immunological perspective. Here, we report a case of successful pregnancy using in vitro fertilisation, in a renal transplant recipient who underwent desensitisation two years prior, that included use of rituximab and plasma exchange to receive an ABO-incompatible transplant from her husband and subsequent father of the baby. We believe this was the first case of successful pregnancy after ABO-incompatible kidney transplantation in Australia and New Zealand. This case also highlights the difficulties faced in conception following transplantation and demonstrates that in vitro fertilisation utilising ovulation induction can be successfully utilised for conception in this cohort. This recipient also had gestational diabetes, worsening renal function and preterm delivery which are important complications often seen in pregnancies of solid organ transplant recipients.

Original languageEnglish
Pages (from-to)42-44
Number of pages3
JournalObstetric Medicine
Volume12
Issue number1
DOIs
Publication statusPublished - 1 Mar 2019
Externally publishedYes

Keywords

  • ABO-incompatible kidney transplant
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Rao, N. N., Wilkinson, C., Morton, M., Bennett, G. D., Russ, G. R., Coates, P. T., & Jesudason, S. (2019). Successful pregnancy in a recipient of an ABO-incompatible renal allograft. Obstetric Medicine, 12(1), 42-44. https://doi.org/10.1177/1753495X17745390