Parenthood in renal homograft recipients

Abstract

Nineteen male recipients of renal homografts were responsible for 23 pregnancies, resulting so far in 19 live births and one abortion; three additional wives have not yet been delivered of infants. Eighteen of the 19 infants were normal; the abnormal infant had a myelomeningocele and other anomalies. Eight female recipients have become pregnant ten times. Two of the pregnancies were terminated with therapeutic abortions, and two more are in progress. The other six resulted in live births. There were only two infants with a completely uncomplicated neonatal period. One premature baby died a few hours after birth from hyaline membrane disease. The other five survived, but one had pulmonary valvular stenosis, two had evidence of transient adrenocortical insufficiency plus lymphopenia, and one child had the respiratory distress syndrome. Renal function of three mothers underwent deterioration during pregnancy, but was restored after its termination

Fig. 1

Intravenous pyelograms. Left, Seventeen months after renal homotransplantation and seven months before pregnancy. Note ureteroureterostomy (arrow). Center, During labor. Pyelogram was obtained in the course of pelvimetry. Right, Thirteen months post partum. Appearance is now similar to before pregnancy (left).

Fig. 2

Intravenous pyelograms. Upper left, Three years after transplantation. Urinary reconstruction was with ureteroneocystostomy. Upper right, Four and a half years after transplantation, 3½ weeks before childbirth. Lower left, During labor. Lower right, Fourteen months post partum. Because of peristalsis, distal ureter (arrow) appears smaller than before pregnancy (upper left).