Successful Pregnancy in a Kidney Transplant Recipient With Chronic Hepatitis B Virus Infection

Authors

  • Waqar Kashif Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
  • Sonia Yaqub Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
  • Hina Ahmed Dow University of Health Sciences, Karachi, Pakistan
  • Nauman Khan Dow University of Health Sciences, Karachi, Pakistan
  • Amna Subhan Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
  • Syed Ather Hussain Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan

Abstract

Overall success rate of pregnancies in kidney transplant recipients is higher than 90% if pregnancy goes beyond the 1st trimester. Risks to mother include hypertension, preeclampsia, infections, and worsening proteinuria, and those to the fetus are prematurity, intrauterine growth retardation, and low birth weight. Hepatitis B infection is associated with progressive liver disease and diminished survival in kidney transplant recipients. A 32-year-old woman had undergone living unrelated donor kidney transplant. Two years after transplantation, she presented with live gestation of 6 weeks. She was also found positive for hepatitis B surface antigen and extracellular antigen. Liver enzymes were normal and ultrasonography findings were normal. Cyclosporine dose was reduced and lamivudine was started. She was monitored closely until 33 weeks, when she gave birth to a healthy female baby through spontaneous vaginal delivery. The newborn received vaccination and immunoglobulins for hepatitis B virus. Mother's kidney allograft function remained stable throughout pregnancy.

Author Biographies

  • Waqar Kashif, Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
    Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Stadium Road, PO Box # 3500, Karachi - 74800, Pakistan
  • Sonia Yaqub, Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
    Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Stadium Road, PO Box # 3500, Karachi - 74800, Pakistan
  • Hina Ahmed, Dow University of Health Sciences, Karachi, Pakistan
    Dow University of Health Sciences, Baba-e-Urdu Road, Karachi- 74200
  • Nauman Khan, Dow University of Health Sciences, Karachi, Pakistan
    Dow University of Health Sciences, Baba-e-Urdu Road, Karachi- 74200
  • Syed Ather Hussain, Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
    Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Stadium Road, PO Box # 3500, Karachi - 74800, Pakistan

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Published

2013-09-27

Issue

Section

CASE REPORT | Transplantation