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Maternity and lung transplantation: cases in Spain
Felipe Zurbano1, Francisco López, Inocencia Fornet
1Unidad de Trasplante Pulmonar, Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain. nmlzgf@humv.es
Insights
Pregnancy after lung transplantation poses significant risks to both mother and child, including hypertension and infection. Doctors should advise lung transplant recipients to avoid pregnancy due to high risks of complications and mortality.
Area of Science:
- Cardiology
- Nephrology
- Obstetrics
- Transplant Surgery
Background:
- Lung transplantation is a life-saving procedure for end-stage lung disease.
- Reproductive outcomes in solid organ transplant recipients are increasingly studied.
- Pregnancy following lung transplantation presents unique challenges for maternal and fetal health.
Observation:
- Data from 18 lung transplant recipients who had children were analyzed.
- Pregnancy complications observed included hypertension (50%), diabetes mellitus (21%), preeclampsia (13%), infection (21%), and rejection (30%).
- Graft function loss occurred in 23% of cases, with a lower live birth rate compared to recipients of other organs.
Findings:
- Maternal complications are frequent, including hypertension and diabetes.
- Fetal risks exist due to immunosuppressive drugs crossing the placenta.
- Metabolic changes during pregnancy can alter drug levels and increase infection risk.
Implications:
- Pregnancy post-lung transplant carries substantial risks for fetal and maternal morbidity and mortality.
- Physicians should counsel lung transplant recipients about the high-risk nature of pregnancy.
- Further research is needed to optimize management and outcomes for pregnant lung transplant recipients.
Abstract:
We contacted and analyzed the data of 18 lung transplant recipients who had had children. The complications we detected included: hypertension (50%), diabetes mellitus (21%), preeclampsia (13%), infection (21%), rejection (30%), loss of graft function (23%) and a lower percentage of live births than in transplant recipients of other organs. Other aspects to keep in mind are: the potential risk for fetal alterations (caused by drugs used as prophylaxis against rejection crossing the placental barrier); greater risk for infection and alterations in drug levels due to changes in metabolism typical of pregnancy and postpartum period. We describe the two cases in Spain of female lung transplant recipients who have had children after transplantation. Although pregnancy in these cases can have a similar evolution as in non-transplanted women, doctors should recommend their transplanted patients to avoid becoming pregnant, while explaining the high risk of both fetal and maternal morbidity and mortality after transplantation.
