PREGNANCY AFTER DONOR NEPHRECTOMY

Potential female donors frequently ask whether unilateral nephrectomy will impair future childbearing capabilities. To address this question , we surveyed 220 women who underwent donor nephrectomy between 1985 a nd 1992. Of the 144 women who responded, 83 became pregnant after dona tion for a total of 45 pregnancies. Seventy-five percent of the pregna ncies were carried to term without difficulty. Complications incurred during gestation included miscarriage (13.3%), preeclampsia (4.4%), ge stational hypertension (4.4%), proteinuria (4.4%), and tubal pregnancy (2.2%). Four of the 45 pregnancies (excluding miscarriages) required preterm hospitalization, resulting in an overall morbid ity of 8.8%. T here were no pregnancy-related deaths, and no fetal abnormalities were reported. Problems with persistent hypertension, proteinuria, or chan ges in renal function were not noted. None of the above complications exceeded what has been noted for the general population. Infertility w as a problem in 8.3% (3/36) of our respondents, compared with a worldw ide incidence of 16.7%. Based on these results, we conclude that donor nephrectomy is not detrimental to the prenatal course or outcome of f uture pregnancies.