cacae0f3ebe4ef4d0af55ba46e8cf6c5 326790.pdf 331a6fa45ecdb96dea71f738eaf759e5c13734f1 326790.pdf cd236040731358501ca3eb9ae17245dd8bb4816b5398bebe9a71d63e21a93edb 326790.pdf Title: A Systematic Review on the Impact of Pregnancy on RenalGraft Function Subject: Background/Objectives: Renal transplantation (RT) represents the optimal treatment for end-stage renal disease (ESRD), offering improved quality of life and restored fertility in women post-transplant. While post-transplant pregnancies are possible, they can lead to complications including pre-eclampsia, graft dysfunction, and other adverse outcomes. This study evaluates existing literature to assess pregnancy’s impact on kidney transplantation outcomes, specifically long-term graft function and survival. Methods: We conducted a systematic review of English-language literature from January 2000 to September 2023 across multiple databases, following PRISMA guidelines. We established inclusion criteria focusing on graft function and adverse events. Two independent reviewers performed data extraction, and we assessed risk of bias using the ROBINS-I tool. Results: From 4917 articles, we included 26 studies encompassing 1202 pregnancies in 902 kidney transplant recipients. Mean maternal age was 30.8 years, with an average interval of 52 months between transplant and pregnancy. Pre-pregnancy hypertension occurred in 54.2% of cases, and pre-eclampsia developed in 25.7%. The live birth rate reached 70.5%, while miscarriage, stillbirth, and neonatal death rates were 11.3%, 2.7%, and 2.5%, respectively. We noticed graft dysfunction during pregnancy in 20.2% of cases. Though kidney function often deteriorated temporarily, most patients recovered post-delivery. Discussion: Post-transplant pregnancies remain viable but high-risk, with elevated rates of obstetric complications. Our findings highlight the need for standardized data collection and reporting to better understand and manage pregnancy’s impact on graft outcomes. Conclusions: With appropriate management, pregnancy in kidney transplant recipients is feasible, though it carries elevated risks of obstetric complications. We recommend further multicenter studies with standardized data collection to improve understanding and outcomes. Keywords: kidney transplant; renal transplant; pregnancy complications; graft function; urological complications; adverse events; pregnancy outcome; maternal outcome; fetal outcome; birth outcome Author: Beatriz Banuelos Marco, Muhammet Irfan Donmez, Batuhan Erkul, Hakan Bahadir Haberal, Alessio Pecoraro, Thomas Prudhomme, Riccardo Campi, Alberto Piana, Alicia Lopez-Abad, Romain Boissier, Albert Breda and Angelo Territo Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Wed Jul 16 05:50:00 2025 CEST ModDate: Wed Jul 16 05:57:33 2025 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 347060 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UZYCGS+URWPalladioL-Bold Type 1 Custom yes yes yes 104 0 UFQUVY+URWPalladioL-Roma Type 1 Custom yes yes yes 105 0 ZTTYLG+URWPalladioL-Ital Type 1 Custom yes yes yes 106 0 DDAKAA+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 131 0 DDAKNC+ArialMT TrueType WinAnsi yes yes no 132 0 DDAJPO+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 133 0 DDAJPP+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 134 0 TFNRKZ+CMSY10 Type 1 Builtin yes yes yes 191 0 BAZSKP+VnURWPalladioL Type 1 Custom yes yes yes 355 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-03-19 04:08:17 CET RepresentationInformation: 326790.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-03-18 12:26:57 CET Size: 347060 Format: PDF Version: 1.5 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 414 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Data Sources and Searches Item: Title: Study Selection Item: Title: Data Extraction, Quality Assessment Item: Title: Results Children: Item: Title: Immunosuppression Item: Title: Pregnancy Outcomes Item: Title: Delivery and Related Adverse Events Item: Title: Kidney Transplant Adverse Events Item: Title: Renal Function Item: Title: Discussion Item: Title: Conclusions Item: Title: References Info: Title: A Systematic Review on the Impact of Pregnancy on RenalGraft Function Author: Beatriz Banuelos Marco, Muhammet Irfan Donmez, Batuhan Erkul, Hakan Bahadir Haberal, Alessio Pecoraro, Thomas Prudhomme, Riccardo Campi, Alberto Piana, Alicia Lopez-Abad, Romain Boissier, Albert Breda and Angelo Territo Subject: Background/Objectives: Renal transplantation (RT) represents the optimal treatment for end-stage renal disease (ESRD), offering improved quality of life and restored fertility in women post-transplant. While post-transplant pregnancies are possible, they can lead to complications including pre-eclampsia, graft dysfunction, and other adverse outcomes. This study evaluates existing literature to assess pregnancy’s impact on kidney transplantation outcomes, specifically long-term graft function and survival. Methods: We conducted a systematic review of English-language literature from January 2000 to September 2023 across multiple databases, following PRISMA guidelines. We established inclusion criteria focusing on graft function and adverse events. Two independent reviewers performed data extraction, and we assessed risk of bias using the ROBINS-I tool. Results: From 4917 articles, we included 26 studies encompassing 1202 pregnancies in 902 kidney transplant recipients. Mean maternal age was 30.8 years, with an average interval of 52 months between transplant and pregnancy. Pre-pregnancy hypertension occurred in 54.2% of cases, and pre-eclampsia developed in 25.7%. The live birth rate reached 70.5%, while miscarriage, stillbirth, and neonatal death rates were 11.3%, 2.7%, and 2.5%, respectively. We noticed graft dysfunction during pregnancy in 20.2% of cases. Though kidney function often deteriorated temporarily, most patients recovered post-delivery. Discussion: Post-transplant pregnancies remain viable but high-risk, with elevated rates of obstetric complications. Our findings highlight the need for standardized data collection and reporting to better understand and manage pregnancy’s impact on graft outcomes. Conclusions: With appropriate management, pregnancy in kidney transplant recipients is feasible, though it carries elevated risks of obstetric complications. We recommend further multicenter studies with standardized data collection to improve understanding and outcomes. 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