Transplant Trial Watch

Long term graft survival and graft function following pregnancy in kidney transplant recipients: a systematic review and meta-analysis.

van Buren, M. C., Schellekens, A. et al. (2019).

Transplantation; [record in progress].

This systematic review and meta-analysis aimed to provide an update on graft survival in non-pregnant kidney transplant recipients, as well as long-term (up to 10 year) graft function, measured by serum creatinine (SCr), after pregnancy.

The Pubmed, Embase and Cochrane library database was searched to identify all studies on SCr and graft loss after pregnancy in kidney transplant recipients up until September 2018.

A total of 38 studies on renal graft loss (n=2453) and 18 studies on renal graft function, as measured by serum creatinine following pregnanct were retrieved for inclusion.

Outcomes being assessed included graft loss, survival and function.

10 years

CET Conclusions
This systematic review and meta-analysis explored the literature on graft outcomes following pregnancy after kidney transplantation. The authors identified 43 studies reporting either graft loss, serum creatinine, or both following transplant. 10 studies also reported a nulliparous control cohort. Overall incidence of graft loss over time is reported, and does not appear to differ significantly to controls (although this comparison was not subjected to meta-analysis). Reported risk factors for graft loss following pregnancy included pre-pregnancy proteinuria, hypertension and poor baseline function. The review is comprehensive and the methodology sound. The data reported are useful when counselling patients and identifying risk factors. One potential limitation is that some patients in the smaller included studies may also be in the larger, registry-based studies leading to double-counting.

Quality notes
SR - Quality Assessment not necessary

Trial registration

Funding source
No funding received