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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 18, 2026; 16(1): 113117
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.113117
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.113117
Successful term pregnancy after renal transplant in end-stage renal disease with complement factor H-related mutation: A case report
Manish Ramesh Balwani, Amit Pasari, Department of Nephrology, Saraswati Kidney Care Center, Nagpur 440015, Maharashtra, India
Manish Ramesh Balwani, Amit Pasari, Charulata Bawankule, Department of Nephrology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha 442001, Maharashtra, India
Pranjal Kashiv, Shubham Dubey, Vijay Jeyachandran, Sunny Malde, Sushrut Gupta, Twinkle Pawar, Mohit Kurundwadkar, Prasad Gurjar, Kapil Sejpal, Department of Nephrology, Jawaharlal Nehru Medical College, Wardha 442001, Mahārāshtra, India
Chaitanya Shembekar, Manisha Shembekar, Department of Gynaecology, Omega Hospital, Nagpur 442005, Mahārāshtra, India
Priyanka Tolani, Department of Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha 442001, Maharashtra, India
Vivek B Kute, Department of Nephrology, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, Gujarat, India
Co-corresponding authors: Manish Ramesh Balwani and Pranjal Kashiv.
Author contributions: Both Balwani MR and Kashiv P made equally significant and complementary contributions to the study’s conception, data analysis, interpretation, and manuscript preparation, and therefore share responsibility as co-corresponding authors. Balwani MR led study design, overall coordination, and drafting of the manuscript, while Kashiv P ensured clinical data accuracy, integration of findings, and critical revision of the manuscript. Their combined supervision and intellectual input were essential for the integrity and completion of the work. Balwani MR was responsible for the conception and design of the study, acquisition, verification, and analysis of data, interpretation of results, and coordination of manuscript preparation and revision. Kashiv P, Kurundwadkar M, Gurjar P, Dubey S, Jeyachandran V, Malde S, Gupta S, Pawar T, Sejpal K, Bawankule C, Pasari A, Shembekar C, Shembekar M, and Tolani P contributed to patient management, data acquisition, and critical review of the manuscript. Kute VB provided critical intellectual input, guidance on study design, and final approval of the manuscript. All authors reviewed and approved the final version and agree to be accountable for all aspects of the work.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Manish Ramesh Balwani, DM, MD, Professor, Department of Neph
Received: August 15, 2025
Revised: September 10, 2025
Accepted: November 21, 2025
Published online: March 18, 2026
Processing time: 152 Days and 13.8 Hours
Revised: September 10, 2025
Accepted: November 21, 2025
Published online: March 18, 2026
Processing time: 152 Days and 13.8 Hours
Core Tip
Core Tip: This case highlights a rare instance of successful term pregnancy in a renal transplant recipient with genetically confirmed complement-mediated thrombotic microangiopathy—homozygous complement factor H exon 17 deletion and complement factor H-related (CFHR3-CFHR1) duplication—managed without complement blockade. Despite the dual risk posed by transplantation and pregnancy, careful preconception counseling, immunosuppressive modification, and vigilant multidisciplinary surveillance ensured stable graft function and favorable maternal-fetal outcomes. This report emphasizes individualized, genotype-informed management and adds valuable evidence to guide pregnancy counseling in women with complement dysregulation post-transplant.