Solid organ Transplant-TOG Flashcards
How many pregnancies with solid organ transplants per year in Uk
50-60 women
Kidney most common
Prevalence of renal transplant in UK
Pregnancies in renal recipients annually
2-6 per 10,000 women of childbearing age
30-40 pregnancies annually
When is conception not advisable
And why
Within first year following transplant
Doses of Immunosuppressants higher and graft stability more difficult to access
What is the risk of acute rejection in the first year
10-15%
Ass with <45 yr of age
What should be done preconception
Prepregnancy counselling important Contraception Previous aetiology and vascular dx function Teratogenic meds stopped Ideally confirm graft stability
What should mycophenolate mofetil be switched to
Azathioprine for 3 months before conception to allow washout
Stop statins before preg
Stop ACE inh and ARBs in pregnancy
What are predictors of bad outcome
Proteinuria and increased Creatinine
How manyRenal Tz will have HTN pre pregnancy?
How many will need to go on Rx in preg
50%
16%
