Pregnancy in kidney transplant recipients

Embarazo en receptoras de trasplante renal

The research describes 21 pregnancies in 19 patients receiving kidney transplants from the San Pedro Claver Clinic in Bogotá, during the period between 1992 and 2003. The importance of the nurse as part of the multidisciplinary team treating this group of patients is highlighted. It implies possessing the knowledge that will support the interventions tending to favor the quality of life. This topic is proposed as the axis of the research, to contribute to the development of further studies that allow the growth of nursing performance in this area. Clinical histories were reviewed, noting what was relevant in the data collection sheet and also direct information was obtained from the patients. It was found that in the post-transplant stage, 11 patients had episodes of rejection prior to pregnancy, menstrual function was still maintained in the presence of chronic renal failure in eight, while in five it was restored at one month and six up to one year later. With regard to the time elapsed between transplantation and pregnancy, an average of 3.35 years was observed, ranging from eight months to seven years. Successful pregnancies were in those who had a creatinine less than 1.5 mg / dL. Five patients with episode of postpartum rejection were found; one presented elevation of creatinine levels at 6.6 mg / dl at the time of delivery, requiring hemodialysis two weeks after birth, another increased creatinine to 3.3 mg / dl at the time of delivery with hemodialysis for one month in the postpartum, the other three required hemodialysis after the first, second and fourth year respectively. Regarding immunosuppressive therapy, there was no change in the dose and interval during pregnancy. Hypertension followed by preeclampsia was the most relevant comorbid factor. There were 17 births, ten at term, seven preterm, one death and three abortions. Caesarean section. As observed in this study group, it can be said that gestation does not seem to cause graft deterioration when pregnancy begins with stable renal function. However, pregnancy in kidney transplant patients should be considered high risk and controlled by a multidisciplinary team.

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