Abstract
Uterus transplant (UTx) is a treatment for uterine factor infertility. Globally, the number of UTx recipients is increasing.
Many recipients have Mayer-Rokitansky-Kuster-Hauser syndrome, which may include unilateral kidney agenesis in addition to a congenitally absent uterus and vaginal aplasia. Therefore, kidney dysfunction is a potential complication of UTx.
We have previously demonstrated that UTx recipients experience a decrease in estimated glomerular filtration rate (eGFR) early posttransplant, that persists into the early postpartum period. We have also demonstrated that the incidence of acute kidney injury (AKI) and preeclampsia (28%) are increased.
However, UTx is a unique transplant paradigm; after childbearing is complete, a graft hysterectomy is performed and immunosuppression is discontinued. The cumulative effect of pregnancy, AKI episodes, preeclampsia, and temporary calcineurin inhibitor (CNI) exposure on longer-term kidney function remains undefined.
We undertook this study in a cohort representing most of the United States UTx population and selected participants from Europe to elucidate intermediate-term kidney outcomes among UTx recipients.