Pregnancy after solid organ transplantation
Pregnancy after solid organ transplantation
For women of reproductive age, the possibility to have children is often an important aspect of their quality of life. Pregnancy after solid organ transplantation is a unique and challenging situation. During pregnancy, major physiological changes occur, and women must continue immunosuppressive medication to prevent graft rejection. This raises questions about the consequences for the mother, the child, and the transplanted organ.
In this thesis of Jildau Meinderts, she studied the long-term outcomes of pregnancies after kidney, liver, heart, and lung transplantation, as well as after kidney donation. Overall, results are reassuring: pregnancy does not appear to have a negative impact on the long-term health of the mother or the transplanted organ. However, overall survival of transplant recipients is lower than that of healthy women and as a result, a substantial proportion of children will lose their mother at a young age. Many families experience their daily life as normal, but especially children were found to experience more anxiety and responsibility than their parents realized. Little is known about the long-term health of children born after transplantation. Therefore, we initiated a nationwide prospective study to assess their health later in life. The second part of my thesis focused on optimizing immunosuppressive therapy during pregnancy, with specific attention to different treatment regimens and to whole-blood and plasma concentrations of tacrolimus.
In summary, this thesis shows that pregnancy after organ transplantation is generally feasible, provided there is careful medical guidance and attention to both medical risks and the impact on the entire family.