Successful pregnancy outcome in a recipient of simultaneous pancreatic kidney transplantation.

There is limited information available regarding post-simultaneous pancreatic kidney transplantation (SPKT) pregnancies. The present case describes a woman in her early 30s with first pregnancy who conceived spontaneously 4 years after SPKT. Her pancreatic and kidney graft function remained stable throughout the pregnancy. Creatinine was 0.6-0.7 mg/dL and Hemoglobin A1C (HbA1C) was 5.1%. There was no pre-eclampsia, gestational diabetes, rejection or infection. There was gestational thrombocytopenia, which was managed conservatively. Tacrolimus levels fell during the antenatal period and subsequently rose post partum. Mycophenolate was discontinued and switched to azathioprine 6 weeks prior. Caesarean section was done at 36 weeks because of oligohydramnios and vaginal warts delivering a healthy, live, full-term baby. Her graft function was stable on follow-up and the baby was doing well. High-risk pregnancies occur in female SPKT recipients. A multidisciplinary team should closely monitor the course of pregnancy events and immunosuppression.