Successful maternal and fetal outcomes in a kidney transplant patient under everolimus throughout pregnancy complicated by pyelonephritis and preeclampsia

Pregnancy in kidney transplant patients has many risks such as worsening renal function and/or proteinuria, allograft rejection, preeclampsia, spontaneous abortion, premature fetal delivery, and low fetal birthweight. We report a case of a 35-year-old patient with a history of kidney transplant, who received everolimus throughout pregnancy and experienced a successful cesarean delivery with positive maternal and fetal outcomes. Information regarding everolimus use in pregnancy is limited. However, data from animal studies suggest that everolimus may cause fetal harm when administered during pregnancy. In our case, everolimus did not affect the pregnancy of this patient; cesarean delivery was performed without complications. Owing to the increased risks and monitoring required during pregnancy in patients with a previous kidney transplant and limited information regarding the use of antirejection agents during pregnancy, care throughout pregnancy should involve a multidisciplinary team, including transplant, maternal fetal medicine, and nephrology.