Pregnancy after kidney donation shows low increased risk for complications
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Among white women, pregnancies after donating a kidney pose similar complications to those experienced by the general population; although, a low increase in risk is observed.
Further, investigators observed similar fetal and neonatal risks among pregnancies before and after donation.
“Understanding and communicating the risk of pregnancy complications post-living kidney donation is imperative as the majority of living kidney donors are women of childbearing age,” Maria Pippias, MBChB, PhD, from Bristol Medical School: Population Health Sciences at the University of Bristol in the United Kingdom, and colleagues wrote. They added, “We performed a systematic review to answer the question ‘Are living kidney donors at an increased risk of pregnancy-induced complications following a donor nephrectomy compared to the risks of pregnancy-induced complications in healthy women who have not undergone a donor nephrectomy?’”
Researchers searched Embase, MEDLINE, PubMed, society webpages and guideline registries for studies that evaluated complications in pregnancies after kidney donations and compared the quality and consistency of related guidelines. The search was limited to research published before Dec. 18, 2020.
Pregnancy complications were considered the primary outcome of the study.
Researchers screened 93 articles, 16 of which were included in the final analysis with a total of 1,399 pregnancies after donation.
Analyses revealed the absolute risk for preeclampsia increased from 1% to 3% before donation (lower than the general population) to 4% to 10% after donation (comparable with the general population). Researchers observed consistent risks for adverse fetal and neonatal outcomes among pregnancies before and after donation. Additionally, guidelines and consensus statements informing living kidney donors of the pregnancy risk after donations were similar, although the depth of the recommendations ranged.
Limitations of the study noted by its researchers include a patient population made up of 98% white women. Therefore, the findings of this review may not be generalizable to women of other ethnicities.
“The increased risk of hypertensive disorders in pregnancy post-donation is evident in four retrospective studies, although all were limited to some extent by sample size and the lack of well-matched controls. Though the relative risk of pregnancy-related complications in living kidney donors increases relative to the risk in the non-donor, the absolute risk remains very low,” Pippias and colleagues wrote. “The risk of long-term complications from hypertensive disorders in pregnancy are minimal.”
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