Pregnancy in Lung Transplant Recipients

Gertner, Gregory; Coscia, Lisa A.; McGrory, Carolyn H.; Moritz, Michael J.; Armenti, Vincent T.

doi:10.1177/152692480001000207

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…As previously described and reaffirmed by the most recent NTPR data, women are capable of having pregnancies after lung transplant. [3][4][5][8][9][10][11][12][13] More than half (18 live births, 56%) of the 30 pregnancies reported resulted in live births, most of which were not associated with life-threatening complications. None of the others were associated with permanent structural defects or disability.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy after Lung Transplant

et al. 2012

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The purpose of this study was to analyze pregnancy outcomes in female lung transplant recipients. Data were collected from the National Transplantation Pregnancy Registry via questionnaires, interviews, and hospital records. Twenty-one female lung recipients reported 30 pregnancies with 32 outcomes (1 triplet pregnancy). Outcomes included 18 live births, 5 therapeutic abortions, and 9 spontaneous abortions. No stillbirths or ectopic pregnancies were reported. Mean (SD) interval from transplant to conception was 3.6 (3.3) years (range, 0.1-11.3 years). Comorbid conditions during pregnancy included hypertension in 16, infections in 7, diabetes in 7, preeclampsia in 1, and rejection in 5 women. Ten of the 21 recipients received a transplant because of cystic fibrosis and accounted for 12 pregnancy outcomes (7 live births, 3 spontaneous abortions, and 2 therapeutic abortions). At last recipient contact, 13 had adequate function, 2 had reduced function, 5 recipients had died (2 with cystic fibrosis), and 1 recipient had a nonfunctioning transplant. Mean gestational age of the newborn was 33.9 (SD, 5.2) weeks, and 11 were born preterm (<37 weeks). Mean birthweight was 2206 (SD, 936) g and 11 were low birthweight (<2500 g). Two neonatal deaths were associated with a triplet pregnancy; one fetus spontaneously aborted at 14 weeks and 2 died after preterm birth at 22 weeks. At last follow-up, all 16 surviving children were reported healthy and developing well. Successful pregnancy is possible after lung transplant, even among recipients with a diagnosis of cystic fibrosis.

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Section: Discussionmentioning

confidence: 99%

Pregnancy after Lung Transplant

et al. 2012

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“…Low birth weight (< 2500 g) occurred in five (56%) of newborn babies. Two newborn babies required ventilatory assistance and one developed necrotising enterocolitis and adrenal suppression (cases 5,7,8). All three recovered completely.…”

Section: Neonatal and Child Outcome (Table 2)mentioning

confidence: 92%

Pregnancy in cystic fibrosis lung transplant recipients: Case series and review

Gyi

Hodson

Yacoub

2006

Journal of Cystic Fibrosis

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A single centre experience of four pregnancies in four cystic fibrosis (CF) lung transplant recipients is reported. Six more cases were identified from the literature review and combined data analysis on 10 pregnancies in 10 CF lung transplant recipients was performed to determine maternal, foetal and graft outcome. There were nine live births and one therapeutic abortion. Three required caesarean sections. Five babies were premature but all nine children were well at follow-up. Five recipients who had a long, stable interval (i.e. at least three years) between transplant and pregnancy had a favourable outcome. Three recipients developed rejection during the pregnancy and one already had obliterative bronchiolitis before pregnancy. All showed progressive decline in lung function and subsequently died of chronic rejection within 38 months of delivery. Pregnancy in CF lung transplant recipients is feasible but should still be regarded as a risky undertaking.

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“…The frequency of live birth after lung transplant is 50–60% [ 1 , 4 , 7 , 12 ], with a relatively high risk of spontaneous or therapeutic abortion [ 12 ]. However, the frequency of congenital malformation for pregnancies in women with a history of solid-organ transplant is similar to that of the general population (3–4%) [ 1 ].…”

Section: Mtor Inhibitorsmentioning

confidence: 99%

Pregnancy after lung transplant

Divithotawela

Chambers

Hopkins

2015

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Improved survival now means that more women with lung transplants than ever before, many of whom have a diagnosis of cystic fibrosis, may be able to consider pregnancy. However, lung transplant recipients have increased risk of maternal and neonatal complications associated with pregnancy [1]. These pregnancies should be planned in advance and closely monitored. Pregnancy should be avoided for a minimum of 1–2 years after transplant to minimise episodes of acute rejection and achieve the lowest possible doses of immunosuppressive drugs. Immunosuppression with mycophenolate mofetil and mammalian target of rapamycin (mTOR) inhibitors should be avoided because of teratogenic effects. Immunosuppression based on prednisolone, azathioprine and calcineurin inhibitors should be established before conception. Vaginal delivery is encouraged due to the lower risk of infection and adverse events of general anaesthesia that may occur with caesarean delivery. Breast feeding is discouraged because of the risk of infant exposure to immunosuppressive drugs via breast milk, though remain a controversial recommendation. We present a patient who had successful pregnancy after lung transplant for cystic fibrosis.

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Pregnancy in Lung Transplant Recipients

Cited by 9 publications

References 18 publications

Pregnancy after Lung Transplant

Pregnancy after Lung Transplant

Pregnancy in cystic fibrosis lung transplant recipients: Case series and review

Pregnancy after lung transplant

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