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Considerations for Living Kidney Donation Among Women of Childbearing Age: Evidence from Recent Studies

  • Live Kidney Donation (KL Lentine, Section Editor)
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Abstract

Each year, approximately 16,000 women become living kidney donors worldwide, donating a kidney to a spouse, family member, or friend. A common concern of women with childbearing potential is whether donation will affect future pregnancy outcomes. The first studies to examine pregnancy outcomes after living kidney donation were mostly reassuring; however, the two largest reported an increased risk of gestational hypertension and preeclampsia in groups of women with pregnancies after donation compared with groups of women with pregnancies before donation. A concern for donation-related risk was recently confirmed in an 11-year cohort study of 85 female donors and 510 healthy non-donors who were carefully matched on baseline risk factors. Donors were 2.4 times more likely to be diagnosed with gestational hypertension or preeclampsia (95 % CI 1.2 to 5.0) compared with healthy non-donors (the combined incidence was 11.5 vs. 4.8 %, respectively). Most donor pregnancies, however, were uncomplicated, with no increased risk for pre-term birth, low birth weight, or Caesarian section and no maternal or neonatal deaths. Importantly, black women were not represented in the three major studies to date, and future research should examine whether risk differs across donor subgroups. As well, a better understanding is needed of the clinical sequelae of gestational hypertension and preeclampsia, including long-term renal outcomes. Based on current evidence, we believe that potential donors with reproductive potential should be counseled on the possibility of a greater likelihood of gestational hypertension or preeclampsia if they choose to donate a kidney, with knowledge that the probability of the most serious outcomes (stillbirth, neonatal death, maternal death) is extremely low.

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Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Westminster Tower, London Health Sciences Centre, 800 Commissioner’s Road East, ELL-215, London, N6A 4G5, ON, Canada

    Jessica M. Sontrop & Amit X. Garg

  2. Department of Epidemiology and Biostatistics, Western University, London, N6A 5C1, ON, Canada

    Jessica M. Sontrop & Amit X. Garg

Authors
  1. Jessica M. Sontrop
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  2. Amit X. Garg
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Correspondence to Jessica M. Sontrop.

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Amit Garg reports grants from Astellas and Roche. Jessica Sontrop has no relevant disclosures.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Live Kidney Donation

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Sontrop, J.M., Garg, A.X. Considerations for Living Kidney Donation Among Women of Childbearing Age: Evidence from Recent Studies. Curr Transpl Rep 3, 10–14 (2016). https://doi.org/10.1007/s40472-016-0082-0

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  • DOI: https://doi.org/10.1007/s40472-016-0082-0

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