Pregnancy in heart transplant recipients – current perspectives

Abstract

William D Watson 1 Sai K Bhagra 2 Catriona J Bhagra 3,4 1Division of Cardiovascular Medicine, University of Oxford, Oxford, UK; 2Transplant Unit, Royal Papworth Hospital, Cambridge, UK; 3Department of Cardiology, Addenbrooke’s Hospital, Cambridge, UK; 4Department of Cardiology, Royal Papworth Hospital, Cambridge, UK Abstract: Successful pregnancy with a live birth and preserved graft function is possible in women following cardiac transplantation but requires careful assessment and planning in conjunction with the co-ordinated care of a specialist multidisciplinary team. Pregnancy poses significant risks to the mother, graft and foetus; these include the challenges of managing immunosuppression to avoid rejection whilst balancing the risks to the foetus from potentially teratogenic medication. This article aims to provide a contemporary perspective on the issues pertaining to pregnancy in heart transplant recipients; describing the pre-conception, pre-partum, intrapartum and postpartum management in this unique group of women.