[Specific experiences in females receiving an organ transplant]

CONTRACEPTION: As in women who do not have a heart transplant, contraception is never perfect, irrespective of the method, intrauterine device (risk of infection), estrogens, progestogens. PREGNANCY: Besides the general effects also observed in all pregnant women, pregnancy in the heart transplant recipient also carries the risk of cytomegalovirus infection and preeclampsia.

Cyclosporin or azathioprine are generally indicated, depending on the individual risks. PREVENTION OF BONE DISEASE: Advice concerning diet and lifestyle should be given prior to transplantation in order to reduce the risk of osteoporosis and osteomalacia. Bone density, particularly of the femoral neck, is essential for screening. A rheumatology examination is also quite useful.

De novo cancer is favored by the use of antilymphocyte inductors. Most are breast cancers (mean delay 60 months); other gynecology cancers develop after about 50 months. The risk of recurrence in patients who had breast cancer is highest during the first 2 years. The risk of recurrent uterine cancer is constantly observed.