Pregnancy after heart transplantation

Czech version

Authors: Hegarová M.
Authors‘ workplace: Klinika kardiologie IKEM, Praha
Published in: Kardiol Rev Int Med 2018, 20(4): 264-268

Overview

The first successful pregnancy after heart transplantation was reported in 1988. Since then few hundreds of women with a transplanted heart have give birth, having healthy baby. Despite the reported successful outcomes, pregnancy for these women should be considered as high risk, especially because of potential maternal complications. We also have to keep in mind the effect of immunosuppressive medication on the foetus, risk of premature delivery and low birthweight and familiar and genetic burden. Therefore, we do not generally recommend pregnancy after heart transplantation. Women who nevertheless insist on pregnancy should meet several conditions. Pregnancy should be avoided during the first year after heart transplantation because of the high risk of transplant rejection. There should not be any history of severe rejection, especially antibody-mediated rejection. Excellent function of the graft should be confirmed without any signs of coronary artery vasculopathy. Mycophenolate mofetil cannot be used in immunosuppressive prophylaxis because of its proven teratogenic risk.

Key words:

heart transplantation – pregnancy – immunosuppressive prophylaxis – rejection

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