Patient Profiles

Gabrielle

Gabrielle always knew she would need a kidney transplant and that day finally came in May 1996 at age 32 when she received a donor kidney from her mother. At age 8 Gabrielle was diagnosed with idiopathic membranous nephritis and was told that by the time she reached 30, she would require dialysis or transplantation. During her childhood she was physically active and involved in school; she never used her disease as an excuse not to do things. Gabrielle always knew she wanted to be a mother but was concerned about whether her renal function could sustain a pregnancy. She finished college, medical school and residency.

At age 30 she married another physician and began discussing pregnancy with her nephrologist but her renal function was too poor. She underwent a renal transplant and then had a difficult post-transplant course. She experienced multiple rejections post-operatively, which were treated with higher doses of immunosuppressants. A major change in immunosuppressive therapy allowed Gabrielle's kidney to finally stabilize. Six months later, she and her husband began to discuss the possibility of having children. Gabrielle sought the advice of other medical professionals, all of whom advised a 2-year wait after transplantation before becoming pregnant. As physicians themselves, they understood the risks. Two years after her transplant, Gabrielle was in good health and she had stable kidney function. Her physician suggested that if they were going to try, this was the time.

Gabrielle made an appointment with a high-risk obstetrician to discuss simple measures that could be taken to increase her chances of becoming pregnant, but before she saw the doctor, she became pregnant. With an uneventful early pregnancy, Gabrielle and her husband were extremely excited. At 36 weeks Gabrielle began to experience slight elevations in her creatinine. Pre-eclampsia was ruled out because she did not have hypertension, protein in her urine, or edema. This trend continued until the thirty-eighth week when her physicians thought it best to induce labor. Gabrielle was able to convince them to wait until the next day, allowing her to contact her mother and her sister who were out-of-state; she wanted her family to be with her. Unfortunately, Gabrielle’s family did not make it to the hospital in time as her labor lasted only a few hours. In February 2001, Madelyn was born and she immediately latched on to her mother’s breast. After extensive research Gabrielle and her husband decided she was going to breastfeed; they knew the benefits of breastfeeding, and in their opinions, there was no definitive contradictory evidence. The only negative thing Gabrielle experienced with breastfeeding was worsened osteoporosis, which was reversed by increased dietary calcium and exercise.

Gabrielle was concerned that Madelyn's exposure to immunosuppressants via breastmilk would make her more susceptible to infections in daycare, but as it turned out Madelyn just brought the infections home and Gabrielle got the colds. Madelyn is developing well; at 4 years, she is extremely bright and even-tempered. Although Gabrielle would have liked to have more children, her physicians believe that the complications at the end of her pregnancy could be a sign of potentially more complicated subsequent pregnancies. Gabrielle is doing well and she does not want to risk any damage to her kidney, besides, Madelyn keeps her very busy.

Reference and Publication Information

The United Network for Organ Sharing is committed to providing accurate and reliable information for transplant patients. To learn more about our content authorship and review process, please read about our Editorial Board.

The content on this page was originally created on August 25, 2005 by the United Network for Organ Sharing and last modified on August 25, 2005. The following sources were used as references:

Armenti, Vincent, et al. "Report from the National Transplantation Pregnancy Registry (NTPR): Outcomes of Pregnancy after Transplantation". 103-113.

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