Pregnancy after transplantation

Armenti, Vincent T.; Ramirez, Carlo B.; Doria, Cataldo; Moritz, Michael J.

doi:10.3109/9781841848235.013

Cited by 21 publications

(47 citation statements)

References 24 publications

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“…The published papers on pregnancy outcomes following kidney transplantation are primarily single‐centre studies or case reports with small samples and no controls. There are a few studies that are based on national registries , but they are limited by short observational periods, the quality and precision of the reported data and the possibilities of reporting and selection bias. The estimates of the risks of complication in these papers vary considerably, indicating the need for additional studies of this group of women.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes following maternal kidney transplantation: a national cohort study

Majak

Sandven

Lorentzen

et al. 2016

Acta Obstet Gynecol Scand

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Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes following maternal kidney transplantation: a national cohort study

Majak

Sandven

Lorentzen

et al. 2016

Acta Obstet Gynecol Scand

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“…Immunosuppression, aged uterus, assisted reproduction and unilateral renal agenesis in women with MRKH syndrome type 2 might increase the risk of pre‐eclampsia in pregnancy after UTx . Similarly, the risk of pre‐eclampsia is increased in young pregnant solid‐organ recipients, who also have a higher risk for premature birth and hypertension . Although a multiparous deceased donor was preferred by the Cleveland team for their UTx in 2016, the authors stated that a nulligravid donor could be considered due to the paucity of available donor organs .…”

Section: Discussionmentioning

confidence: 99%

Clinical pregnancy after deceased donor uterus transplantation: Lessons learned and future perspectives

Chmel

Pastor

Nováčková

et al. 2019

J of Obstet and Gynaecol

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Aim: To describe our first clinical pregnancy following a uterus transplant from a brain-dead donor and to discuss current issues with deceased donor uterus transplantation as they relate to obstetrical success. Methods: In August 2016, a 26-year-old woman with Mayer-Rokitansky-Küster-Hauser syndrome was the fourth person worldwide to receive a uterine transplant from a deceased donor and was the second in our trial. in vitro fertilization treatments using the long gonadotropin-releasing hormone agonist protocol preceded the transplantation procedure. Frozen embryo transfers were performed in months 12, 13, 16, 19 and 23 after transplant. Results: Recovery of the uterus of a 24-year-old brain-dead nulliparous donor and the transplant procedure itself was uncomplicated. No abnormalities were revealed on Pap smears, which were performed every 6 months during the post-transplant period, and cervical biopsies showed no epithelial dysplasia. The fifth frozen embryo transfer resulted in a clinical pregnancy. Three weeks after embryo transfer, an intrauterine gestational sac containing an embryo with a heartbeat was detected. One week later, signs of a missed abortion were revealed by ultrasound. Two weeks later, spontaneous bleeding occurred, and an ultrasound examination performed a week later confirmed an empty uterine cavity. Conclusion: In light of present research, both deceased donor uterine procurement and transplantation surgeries are technically feasible; however, more experience is needed to determine the pregnancy success rate associated with this method. Thus, additional trials of deceased donor uterine transplantation should be performed in the future to continue research related to this promising concept for the treatment of absolute uterine factor infertility.

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“…In the case of pregnancy after HTx, there could be multiple complications including acute graft rejection and fetal complications. 4,6) The US National Transplantation Pregnancy Registry in 2009 reported that HTx recipients experienced higher acute graft rejection (21%) compared with other solid organ transplant recipients. 3) Although most of them were mild and required no specific treatment, 7) some presented with severe rejection accompanied by graft loss.…”

Section: Discussionmentioning

confidence: 99%

Successful Pregnancy and Delivery in a Heart Transplantation Recipient

et al. 2016

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For 6 years after heart transplantation, a 23-year old female recipient had been treated with immunosuppressants including tacrolimus and mycophenolate mofetil (MMF), without any major rejection or graft dysfunction. She unexpectedly became pregnant for the first time, and we converted MMF to azathioprine (AZA), but she soon experienced a spontaneous abortion. After careful counseling under the continuation of AZA, she became pregnant again 3 months after the abortion. We closely monitored the concentration of immunosuppressive agents, cardiac function, fetal condition, and serological assay including human leukocyte antigen (HLA) sensitization, and she eventually delivered a normal male infant at 38 weeks gestation without any complications. AZA was converted to MMF soon after the delivery. There have been no complications in either the patient or infant after the delivery.Because pregnancy itself involves a risk of cardiac graft rejection in the recipient as well as fetal complications, it is important to educate HTx recipients about planned pregnancy and to conduct careful follow-up after pregnancy.

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Pregnancy after transplantation

Cited by 21 publications

References 24 publications

Pregnancy outcomes following maternal kidney transplantation: a national cohort study

Pregnancy outcomes following maternal kidney transplantation: a national cohort study

Clinical pregnancy after deceased donor uterus transplantation: Lessons learned and future perspectives

Successful Pregnancy and Delivery in a Heart Transplantation Recipient

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