A recent study from July 2017 investigates the short-term kidney function in newborns with Twin to Twin Transfusion Syndrome (TTTS). It was published in the European Journal of Pediatrics. It’s the first study on short-term kidney function in a large cohort of TTTS twins treated with or without laser surgery, assessing also the impact of incomplete laser treatment. 312 twins fulfilled the criteria of the study and were divided into two groups. One group that was treated with fetoscopic laser surgery and one group that was treated conservatively. In the non-laser group, babies were treated with either serial amnioreduction or expectant management. The children were all treated at the Leiden University Medical Center in The Netherlands. They were born between July 2009 and June 2016. Leiden University Medical Center serves as the national referral center for monochorionic twin pregnancies with TTTS in the Netherlands.
Risk of long-term kidney dysfunction
274 twin pairs were treated with fetoscopic laser surgery. 228 pairs had successful laser surgeries and 46 twin pairs had incomplete laser surgeries. 38 twins were treated conservatively and managed either expectantly or with serial amniodrainage. The researchers found that the incidence of short-term kidney failure in TTTS twins treated with laser surgery is low. This is despite of the fact that the donor twins before surgery suffered from severe oliguria – low output of urine – and oligohydramnios – a deficiency of amniotic fluid. This suggests that laser surgery may have a protective effect on kidney function. The researchers also found that after incomplete laser surgery, the incidence of short-term kidney dysfunction increases. The twin pairs who experienced incomplete laser surgery developed recurrent or reversal of TTTS. Some developed post-laser Twin Anemia Polycythemia Sequence (TAPS). The researchers recommend that another study is initiated to evaluate the risk of kidney dysfunction long-term.
Read our TTTS and TAPS survivors stories