19. Pregnancy in Transplant Patients

  1. John T. Queenan MD2,
  2. Catherine Y. Spong MD3 and
  3. Charles J. Lockwood MD4
  1. James R. Scott MD

Published Online: 4 JAN 2012

DOI: 10.1002/9781119963783.ch19

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

How to Cite

Scott, J. R. (2012) Pregnancy in Transplant Patients, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch19

Editor Information

  1. 2

    Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA

  2. 3

    Bethesda, MD, USA

  3. 4

    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Author Information

  1. Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA

Publication History

  1. Published Online: 4 JAN 2012
  2. Published Print: 24 FEB 2012

ISBN Information

Print ISBN: 9780470655764

Online ISBN: 9781119963783

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Keywords:

  • pregnancy in transplant patients;
  • chronic renal failure, or end-stage renal disease;
  • kidney transplantation, a longer life than with dialysis;
  • transplantation, treatment of choice in end-stage disease;
  • female transplant recipients, and preconception counseling;
  • immunosuppressive agents, potential side-effects;
  • kidney transplant patients, and pyelonephritis;
  • fetal risk, immunosuppressive drugs in transplantation;
  • HBV, HCV and dialysis, blood transfusions, prior to transplantation;
  • offspring exposure to agents, and long-term follow-up

Summary

Chronic renal failure or end-stage renal disease affects over 20 million people in the USA alone. These patients have only two treatment options for survival: dialysis or a kidney transplant. Kidney transplantation leads to a longer life than dialysis, restores many patients to near normal lifestyles, and is cost-effective for the healthcare system. The donor kidney is surgically placed extraperitoneally in the recipient's iliac fossa. The procedure is accomplished by anastomosing the donor renal artery to the proximal end of the divided hypogastric artery and the donor renal vein to the external iliac vein or anastomosing the donor renal artery directly to the external iliac artery. The donor ureter is then attached to the recipient's bladder by ureteroneocystostomy. Transplantation has also evolved as the treatment of choice or only option for many women of reproductive age with end-stage liver, heart, and lung disease.