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Z Geburtshilfe Neonatol 2022; 226(02): 86-91
DOI: 10.1055/a-1710-4097
Review

Pregnancy After Simultaneous Pancreas-Kidney Transplantation in Treatment of End-Stage Diabetes Mellitus: a Review

Zana Stanic
1   Department for Integrative Gynecology, Obstetrics and Minimally invasive Gynecologic Surgery, Zabok General Hospital, Zabok, Croatia
,
Marko Vulic
2   Department of Gynaecology and Obstetrics, Clinical Hospital Center Split, Split, Croatia
,
Zlatko Hrgovic
3   Gynecology and Women's Health Department, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
,
Rajko Fureš
1   Department for Integrative Gynecology, Obstetrics and Minimally invasive Gynecologic Surgery, Zabok General Hospital, Zabok, Croatia
,
Milvija Plazibat
4   Department of Pediatrics, Zabok General Hospital, Zabok, Croatia
,
Esma Cecuk
5   Center for transfusion and transplant medicine, Clinical Hospital Center Split, Split, Croatia
,
Iva Vusic
6   Emergency Department, Bjelovar General Hospital, Bjelovar, Croatia
,
Marko Lagancic
7   Emergency Department, Dubrava Clinical Hospital, Zagreb, Croatia
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Abstract

The majority of patients with simultaneous pancreas and kidney transplant (SPKT) required transplantation owing to a long-standing history of insulin-dependent diabetes mellitus (IDDM). The disease causes multiple organ damage, impairs fertility, and affects quality of life. A successful kidney and pancreas transplant can improve health, ameliorate the consequences of pre-existent diabetes, and restore fertility. Good graft function, without any sign of rejection, and stable doses of immunosuppressant drugs are of utmost importance prior to the planned pregnancy. SPKT recipients who become pregnant may be at an increased risk for an adverse outcome and require meticulous multidisciplinary surveillance. We present experiences with SPKT pregnancies, traditional approaches, and recent considerations. In light of complex interactions between new anatomic relations and the impact of developing pregnancy and immunosuppressive medications, special stress is put on the risk of graft rejection, development of pregnancy complications, and potential harmful effects on fetal development. Recent recommendations in management of SPKT recipients who wish to commence pregnancy are presented as well. Key words: transplantation, pregnancy, pancreas, kidney, simultaneous pancreas and kidney transplantation (SPKT)

Key words

transplantation - pregnancy - pancreas - kidney - simultaneous pancreas and kidney transplantation (SPKT)


Publication History

Received: 14 November 2021

Accepted: 21 November 2021

Article published online:
21 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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