Pregnancy outcomes in simultaneous pancreas and kidney transplant recipients: a national French survey study
Summary Simultaneous pancreas and kidney transplantation (SPK) is currently the best therapeutic option for patients with type 1 diabetes and terminal renal failure. Renal transplantation restores fertility enabling women to pursue pregnancies. However, scarcity of available data on pregnancy outcom...
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| Veröffentlicht in: | Transplant international 2017-09, Vol.30 (9), p.893-902 |
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| creator | Normand, Gabrielle Brunner, Flora Badet, Lionel Buron, Fanny Catton, Marielle Massardier, Jérôme Esposito, Laure Grimbert, Philippe Mourad, Georges Serre, Jean E. Caillard, Sophie Karam, Georges Cantarovich, Diego Morelon, Emmanuel Thaunat, Olivier |
| description | Summary
Simultaneous pancreas and kidney transplantation (SPK) is currently the best therapeutic option for patients with type 1 diabetes and terminal renal failure. Renal transplantation restores fertility enabling women to pursue pregnancies. However, scarcity of available data on pregnancy outcomes in SPK impedes fair medical counseling. Medical files of all pregnancies that lasted ≥3 months among recipients of functional SPK performed between 1990 and 2015 in France were retrospectively analyzed. Twenty‐six pregnancies in 22 SPK recipients were identified. Main maternal complications included gestational hypertension (53.8%) and infections (50%). Cesarean section was performed in 73% of cases. Overall fetal survival was 92.6% with a mean gestational age of 34.2 ± 3 weeks. Four children (16.7% of live births) had a birth weight |
| doi_str_mv | 10.1111/tri.12983 |
| format | Article |
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Simultaneous pancreas and kidney transplantation (SPK) is currently the best therapeutic option for patients with type 1 diabetes and terminal renal failure. Renal transplantation restores fertility enabling women to pursue pregnancies. However, scarcity of available data on pregnancy outcomes in SPK impedes fair medical counseling. Medical files of all pregnancies that lasted ≥3 months among recipients of functional SPK performed between 1990 and 2015 in France were retrospectively analyzed. Twenty‐six pregnancies in 22 SPK recipients were identified. Main maternal complications included gestational hypertension (53.8%) and infections (50%). Cesarean section was performed in 73% of cases. Overall fetal survival was 92.6% with a mean gestational age of 34.2 ± 3 weeks. Four children (16.7% of live births) had a birth weight <10th percentile. Endocrine pancreas graft function remained stable during pregnancy. An acute kidney rejection occurred in two patients, one of which resulting in graft loss. Kidney and pancreas graft survival was, respectively, 96% and 100% at 1 year postconception and did not differ from controls. Pregnancy in SPK is feasible, but patients should be informed of the risks for the fetus, the mother, and the grafts. Planning of pregnancy in SPK women is key to allow a personalized multidisciplinary monitoring, which represents the most straightforward approach to optimize outcomes.</description><identifier>ISSN: 0934-0874</identifier><identifier>EISSN: 1432-2277</identifier><identifier>DOI: 10.1111/tri.12983</identifier><identifier>PMID: 28500781</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Birth weight ; Cesarean section ; Children ; Complications ; Diabetes mellitus ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - surgery ; Female ; Fertility ; Fetuses ; Follow-Up Studies ; France ; Gestational age ; Graft rejection ; Graft Survival ; Grafting ; Grafts ; Health risk assessment ; Humans ; Hypertension ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - surgery ; Kidney transplantation ; Kidney Transplantation - methods ; Kidney transplants ; Life Sciences ; Pancreas ; Pancreas transplantation ; Pancreas Transplantation - methods ; Patients ; Postoperative Complications - epidemiology ; Pregnancy ; Pregnancy - statistics & numerical data ; Pregnancy complications ; Pregnancy Complications - epidemiology ; Pregnancy Complications - etiology ; Pregnancy Outcome ; Rejection ; Renal failure ; Retrospective Studies ; simultaneous pancreas and kidney transplantation ; Survival ; Transplantation ; Transplants & implants ; Treatment Outcome ; Xenografts</subject><ispartof>Transplant international, 2017-09, Vol.30 (9), p.893-902</ispartof><rights>2017 Steunstichting ESOT</rights><rights>2017 Steunstichting ESOT.</rights><rights>Copyright © 2017 Steunstichting ESOT. Published by John Wiley & Sons Ltd</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4223-63964912d860ea4a006bd21aa3a40c6b5410c5c1f8a27fe3da11c5e393278f8d3</citedby><cites>FETCH-LOGICAL-c4223-63964912d860ea4a006bd21aa3a40c6b5410c5c1f8a27fe3da11c5e393278f8d3</cites><orcidid>0000-0002-3648-8963 ; 0000-0002-8235-2864</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftri.12983$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftri.12983$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1416,27915,27916,45565,45566</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28500781$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-01761616$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Normand, Gabrielle</creatorcontrib><creatorcontrib>Brunner, Flora</creatorcontrib><creatorcontrib>Badet, Lionel</creatorcontrib><creatorcontrib>Buron, Fanny</creatorcontrib><creatorcontrib>Catton, Marielle</creatorcontrib><creatorcontrib>Massardier, Jérôme</creatorcontrib><creatorcontrib>Esposito, Laure</creatorcontrib><creatorcontrib>Grimbert, Philippe</creatorcontrib><creatorcontrib>Mourad, Georges</creatorcontrib><creatorcontrib>Serre, Jean E.</creatorcontrib><creatorcontrib>Caillard, Sophie</creatorcontrib><creatorcontrib>Karam, Georges</creatorcontrib><creatorcontrib>Cantarovich, Diego</creatorcontrib><creatorcontrib>Morelon, Emmanuel</creatorcontrib><creatorcontrib>Thaunat, Olivier</creatorcontrib><title>Pregnancy outcomes in simultaneous pancreas and kidney transplant recipients: a national French survey study</title><title>Transplant international</title><addtitle>Transpl Int</addtitle><description>Summary
Simultaneous pancreas and kidney transplantation (SPK) is currently the best therapeutic option for patients with type 1 diabetes and terminal renal failure. Renal transplantation restores fertility enabling women to pursue pregnancies. However, scarcity of available data on pregnancy outcomes in SPK impedes fair medical counseling. Medical files of all pregnancies that lasted ≥3 months among recipients of functional SPK performed between 1990 and 2015 in France were retrospectively analyzed. Twenty‐six pregnancies in 22 SPK recipients were identified. Main maternal complications included gestational hypertension (53.8%) and infections (50%). Cesarean section was performed in 73% of cases. Overall fetal survival was 92.6% with a mean gestational age of 34.2 ± 3 weeks. Four children (16.7% of live births) had a birth weight <10th percentile. Endocrine pancreas graft function remained stable during pregnancy. An acute kidney rejection occurred in two patients, one of which resulting in graft loss. Kidney and pancreas graft survival was, respectively, 96% and 100% at 1 year postconception and did not differ from controls. Pregnancy in SPK is feasible, but patients should be informed of the risks for the fetus, the mother, and the grafts. Planning of pregnancy in SPK women is key to allow a personalized multidisciplinary monitoring, which represents the most straightforward approach to optimize outcomes.</description><subject>Adult</subject><subject>Birth weight</subject><subject>Cesarean section</subject><subject>Children</subject><subject>Complications</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - surgery</subject><subject>Female</subject><subject>Fertility</subject><subject>Fetuses</subject><subject>Follow-Up Studies</subject><subject>France</subject><subject>Gestational age</subject><subject>Graft rejection</subject><subject>Graft Survival</subject><subject>Grafting</subject><subject>Grafts</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - surgery</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - methods</subject><subject>Kidney transplants</subject><subject>Life Sciences</subject><subject>Pancreas</subject><subject>Pancreas transplantation</subject><subject>Pancreas Transplantation - methods</subject><subject>Patients</subject><subject>Postoperative Complications - epidemiology</subject><subject>Pregnancy</subject><subject>Pregnancy - statistics & numerical data</subject><subject>Pregnancy complications</subject><subject>Pregnancy Complications - epidemiology</subject><subject>Pregnancy Complications - etiology</subject><subject>Pregnancy Outcome</subject><subject>Rejection</subject><subject>Renal failure</subject><subject>Retrospective Studies</subject><subject>simultaneous pancreas and kidney transplantation</subject><subject>Survival</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><subject>Xenografts</subject><issn>0934-0874</issn><issn>1432-2277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kVFrFTEQhYMo9lp98A9IwJf6sG0myd1NfCvF2sIFRepzmJvN2tRsdk12K_vvzXVrBcEJzIHk40yGQ8hrYKdQ6mxK_hS4VuIJ2YAUvOK8aZ6SDdNCVkw18oi8yPmOMcbVlj0nRwdhjYINCZ-T-xYx2oUO82SH3mXqI82-n8OE0Q1zpmN5Tg4zxdjS776NbqFTwpjHgHGiyVk_ehen_J4ijTj5IWKgl8lFe0vznO4Ln6e5XV6SZx2G7F496DH5evnh5uKq2n36eH1xvqus5FxUtdC11MBbVTOHEhmr9y0HRIGS2Xq_lcDs1kKnkDedEy0C2K0TWvBGdaoVx-Td6nuLwYzJ95gWM6A3V-c7c7hj0NRQzj0U9mRlxzT8mF2eTO-zdSGsyxtQWkNpvC7o23_Qu2FOZddCaa6FqkHIv8NtGnJOrnv8ATBziMuUuMzvuAr75sFx3veufST_5FOAsxX46YNb_u9kbr5cr5a_ABXonrU</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>Normand, Gabrielle</creator><creator>Brunner, Flora</creator><creator>Badet, Lionel</creator><creator>Buron, Fanny</creator><creator>Catton, Marielle</creator><creator>Massardier, Jérôme</creator><creator>Esposito, Laure</creator><creator>Grimbert, Philippe</creator><creator>Mourad, Georges</creator><creator>Serre, Jean E.</creator><creator>Caillard, Sophie</creator><creator>Karam, Georges</creator><creator>Cantarovich, Diego</creator><creator>Morelon, Emmanuel</creator><creator>Thaunat, Olivier</creator><general>Blackwell Publishing Ltd</general><general>Frontiers Media</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-3648-8963</orcidid><orcidid>https://orcid.org/0000-0002-8235-2864</orcidid></search><sort><creationdate>201709</creationdate><title>Pregnancy outcomes in simultaneous pancreas and kidney transplant recipients: a national French survey study</title><author>Normand, Gabrielle ; Brunner, Flora ; Badet, Lionel ; Buron, Fanny ; Catton, Marielle ; Massardier, Jérôme ; Esposito, Laure ; Grimbert, Philippe ; Mourad, Georges ; Serre, Jean E. ; Caillard, Sophie ; Karam, Georges ; Cantarovich, Diego ; Morelon, Emmanuel ; Thaunat, Olivier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4223-63964912d860ea4a006bd21aa3a40c6b5410c5c1f8a27fe3da11c5e393278f8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Birth weight</topic><topic>Cesarean section</topic><topic>Children</topic><topic>Complications</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - surgery</topic><topic>Female</topic><topic>Fertility</topic><topic>Fetuses</topic><topic>Follow-Up Studies</topic><topic>France</topic><topic>Gestational age</topic><topic>Graft rejection</topic><topic>Graft Survival</topic><topic>Grafting</topic><topic>Grafts</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - surgery</topic><topic>Kidney transplantation</topic><topic>Kidney Transplantation - methods</topic><topic>Kidney transplants</topic><topic>Life Sciences</topic><topic>Pancreas</topic><topic>Pancreas transplantation</topic><topic>Pancreas Transplantation - methods</topic><topic>Patients</topic><topic>Postoperative Complications - epidemiology</topic><topic>Pregnancy</topic><topic>Pregnancy - statistics & numerical data</topic><topic>Pregnancy complications</topic><topic>Pregnancy Complications - epidemiology</topic><topic>Pregnancy Complications - etiology</topic><topic>Pregnancy Outcome</topic><topic>Rejection</topic><topic>Renal failure</topic><topic>Retrospective Studies</topic><topic>simultaneous pancreas and kidney transplantation</topic><topic>Survival</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><topic>Xenografts</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Normand, Gabrielle</creatorcontrib><creatorcontrib>Brunner, Flora</creatorcontrib><creatorcontrib>Badet, Lionel</creatorcontrib><creatorcontrib>Buron, Fanny</creatorcontrib><creatorcontrib>Catton, Marielle</creatorcontrib><creatorcontrib>Massardier, Jérôme</creatorcontrib><creatorcontrib>Esposito, Laure</creatorcontrib><creatorcontrib>Grimbert, Philippe</creatorcontrib><creatorcontrib>Mourad, Georges</creatorcontrib><creatorcontrib>Serre, Jean E.</creatorcontrib><creatorcontrib>Caillard, Sophie</creatorcontrib><creatorcontrib>Karam, Georges</creatorcontrib><creatorcontrib>Cantarovich, Diego</creatorcontrib><creatorcontrib>Morelon, Emmanuel</creatorcontrib><creatorcontrib>Thaunat, Olivier</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Transplant international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Normand, Gabrielle</au><au>Brunner, Flora</au><au>Badet, Lionel</au><au>Buron, Fanny</au><au>Catton, Marielle</au><au>Massardier, Jérôme</au><au>Esposito, Laure</au><au>Grimbert, Philippe</au><au>Mourad, Georges</au><au>Serre, Jean E.</au><au>Caillard, Sophie</au><au>Karam, Georges</au><au>Cantarovich, Diego</au><au>Morelon, Emmanuel</au><au>Thaunat, Olivier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pregnancy outcomes in simultaneous pancreas and kidney transplant recipients: a national French survey study</atitle><jtitle>Transplant international</jtitle><addtitle>Transpl Int</addtitle><date>2017-09</date><risdate>2017</risdate><volume>30</volume><issue>9</issue><spage>893</spage><epage>902</epage><pages>893-902</pages><issn>0934-0874</issn><eissn>1432-2277</eissn><abstract>Summary
Simultaneous pancreas and kidney transplantation (SPK) is currently the best therapeutic option for patients with type 1 diabetes and terminal renal failure. Renal transplantation restores fertility enabling women to pursue pregnancies. However, scarcity of available data on pregnancy outcomes in SPK impedes fair medical counseling. Medical files of all pregnancies that lasted ≥3 months among recipients of functional SPK performed between 1990 and 2015 in France were retrospectively analyzed. Twenty‐six pregnancies in 22 SPK recipients were identified. Main maternal complications included gestational hypertension (53.8%) and infections (50%). Cesarean section was performed in 73% of cases. Overall fetal survival was 92.6% with a mean gestational age of 34.2 ± 3 weeks. Four children (16.7% of live births) had a birth weight <10th percentile. Endocrine pancreas graft function remained stable during pregnancy. An acute kidney rejection occurred in two patients, one of which resulting in graft loss. Kidney and pancreas graft survival was, respectively, 96% and 100% at 1 year postconception and did not differ from controls. Pregnancy in SPK is feasible, but patients should be informed of the risks for the fetus, the mother, and the grafts. Planning of pregnancy in SPK women is key to allow a personalized multidisciplinary monitoring, which represents the most straightforward approach to optimize outcomes.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>28500781</pmid><doi>10.1111/tri.12983</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3648-8963</orcidid><orcidid>https://orcid.org/0000-0002-8235-2864</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Transplant international, 2017-09, Vol.30 (9), p.893-902 |
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| language | eng |
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| source | Wiley-Blackwell Journals; MEDLINE; EZB Electronic Journals Library |
| subjects | Adult Birth weight Cesarean section Children Complications Diabetes mellitus Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - surgery Female Fertility Fetuses Follow-Up Studies France Gestational age Graft rejection Graft Survival Grafting Grafts Health risk assessment Humans Hypertension Kidney Failure, Chronic - complications Kidney Failure, Chronic - surgery Kidney transplantation Kidney Transplantation - methods Kidney transplants Life Sciences Pancreas Pancreas transplantation Pancreas Transplantation - methods Patients Postoperative Complications - epidemiology Pregnancy Pregnancy - statistics & numerical data Pregnancy complications Pregnancy Complications - epidemiology Pregnancy Complications - etiology Pregnancy Outcome Rejection Renal failure Retrospective Studies simultaneous pancreas and kidney transplantation Survival Transplantation Transplants & implants Treatment Outcome Xenografts |
| title | Pregnancy outcomes in simultaneous pancreas and kidney transplant recipients: a national French survey study |
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