Pregnancy and Birth After Kidney Donation: The Norwegian Experience

• Published in: American journal of transplantation Vol. 9; no. 4; pp. 820 - 824
• Main Authors: Reisæter, A. V., Røislien, J., Henriksen, T., Irgens, L. M., Hartmann, A.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.04.2009; Wiley
• Subjects: Adult; Biological and medical sciences; Female; Fetal Development - physiology; Humans; Living donor transplantation; Living Donors; Medical sciences; Nephrectomy - adverse effects; Norway - epidemiology; Parity; Pre-Eclampsia - epidemiology; Pregnancy; Pregnancy Complications - epidemiology; Pregnancy Outcome; Premature Birth - epidemiology; Reference Values; Reproducibility of Results; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; transplantation; Norway; Europe; ANE, Norway; Human; Living donor; Transplantation; Living donor transplantation; Homotransplantation; Birth; Kidney; Pregnancy; Experience; Treatment; Urinary system; Surgery; Graft; Female; Woman
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2008.02427.x

Reports on pregnancies in kidney donors are scarce. The aim was to assess pregnancy outcomes for previous donors nationwide. The Medical Birth Registry of Norway holds records of births since 1967. Linkage with the Norwegian Renal Registry provided data on pregnancies of kidney donors 1967–2002. A random sample from the Medical Birth Registry was control group, as was pregnancies in kidney donors prior to donation. Differences between groups were assessed by two‐sided Fisher's exact tests and with generalized linear mixed models (GLMM). We identified 326 donors with 726 pregnancies, 106 after donation. In unadjusted analysis (Fisher) no differences were observed in the occurrence of preeclampsia (p = 0.22). In the adjusted analysis (GLMM) it was more common in pregnancies after donation, 6/106 (5.7%), than in pregnancies before donation 16/620 (2.6%) (p = 0.026). The occurrence of stillbirths after donation was 3/106 (2.8%), before donation 7/620 (1.1%), in controls (1.1%) (p = 0.17). No differences were observed in the occurrence of adverse pregnancy outcome in kidney donors and in the general population in unadjusted analysis. Our finding of more frequent preeclampsia in pregnancies after kidney donation in the secondary analysis must be interpreted with caution, as the number of events was low. This registry study from 1967 through 2002 reporting on 106 pregnancies after kidney donation shows that pregnancy generally is safe in these women, slightly increased preeclampsia in the secondary analysis must be interpreted with caution due to a low number of cases and events. See article by Ibrahim et al on page 825 & viewpoint by Nevis and Garg on page 661