New research reassures mums about common pregnancy complication after kidney transplant

Women who have received a kidney transplant can now make more informed choices about pregnancy thanks to new research uncovering missing information about the potential risks to their transplant.

In the largest study of its kind, the research from the Central and Northern Adelaide Renal and Transplantation Service (CNARTS) revealed that despite a rising rate of pre-eclampsia during pregnancy, it does not affect the long-term function or survival of their transplant.

Full of uncertainty

Kidney transplantation offers the opportunity to achieve parenthood, which is a priority for many women with kidney failure.

Women with a kidney transplant are six times more likely to develop pre-eclampsia during pregnancy, a serious complication that could threaten the health of a transplanted kidney, the mother, and the baby.

With a lack of research data detailing the precise risks to transplant function and survival after pregnancy with pre-eclampsia, patients and doctors have always worried about what impact a pregnancy might have on a kidney transplant, according to Clinical Associate Professor Shilpa Jesudason, Chair of the Clinical Research Group CNARTS and Pregnancy and Kidney Research Australia, based at the Royal Adelaide Hospital.

“The kidneys work twice as hard during pregnancy. Pre-eclampsia is a potentially dangerous complication of pregnancy where blood pressure is high and the kidneys are under even more strain” said Clinical A/Prof Jesudason.

“We knew women with kidney disease and transplants are more likely to get pre-eclampsia – what we didn’t know was whether this affected the transplant in the long term, after the baby is delivered.”

Data-backed decisions

In the largest known study if its kind, Clinical A/Prof Jesudason and her colleagues analysed data from a large national registry, focusing on 390 pregnancies after kidney transplant during 2000-2021.

They found that the rate of pre-eclampsia has nearly doubled but did not negatively affect kidney function or impact the survival of transplants.

“These data are very reassuring to women, their families, their donors and their doctors! The risk of losing a kidney transplant due to pregnancy, even with pre-eclampsia, is low,” said Clinical A/Prof Jesudason.

Our study also shows pre-eclampsia rates are rising – perhaps we are better at diagnosing it, or perhaps the new transplant drugs contribute. Either way, this study tells us we need to watch these women very carefully in pregnancy, and make sure we do everything we can to prevent pre-eclampsia and pick it up early.”

This study was published in the prestigious kidney health journal and selected for editorial comment highlighting its importance.

“Publishing this work in an international leading journal shows that these data are of great interest to the kidney community and might help our daily clinical practice. We are also delighted to see CJASN placing such value on women’s health issues, this is an area of kidney research that is rapidly expanding, and clinicians are now giving it priority.” said Dr Jesudason.

Read the research

Click here to read the published paper. The importance of this work was highlighted in an editorial in the journal which you can read here.

You can hear more about Shilpa’s work on the Research Pulse podcast.