Pregnancy After Kidney Donation: The Experience in a Cohort of Portuguese Living Donors.

Background: Living kidney donation (LKD) is a preferred treatment option for end-stage chronic kidney disease, but it can also pose potential risks for the donor, including hypertension and end-stage renal disease. Many donors are women of reproductive age who may have concerns about the effects of donation on future pregnancies. The aim of this study was to determine fetal and maternal outcomes in a cohort of pregnancies after LKD and to compare them with pregnancies before LKD.

Methods: We conducted a retrospective analysis of living kidney donors of childbearing age (<46 years old) at the time of donation who got pregnant after LKD in our center between 1987 and 2020 (N = 13). Clinical data were collected, including demographic characteristics and maternal and fetal outcomes.

Results: We observed 16 pregnancies after LKD and 12 pregnancies before LKD in the same group of patients. The rate of gestational hypertension was 12.5% in pregnancies after LKD and 8.3% before LKD (P = .999). There were 13 successful pregnancies after LKD with a mean gestational age of 38.6 ± 1.7 weeks. There were no episodes of acute kidney injury or other complications.

Conclusion: The present study suggests that LKD does not have a negative effect on maternal and fetal outcomes. However, caution should be taken due to the small sample size. We agree with the guidelines recommending close monitoring of post-donation pregnancies.