Heart Transplantation in Women

Over the past 5 decades, heart transplantation has become an established therapy with greater quality of life and survival than expected from end-stage heart failure. Nonetheless, challenges still exist, especially for women undergoing heart transplantation. Women have greater post-transplant survival than their male counterparts but worse quality of life. Pregnancy may occur, especially because more women are reaching child-bearing age after transplantation. Successful outcomes have been reported but require a systematic multidisciplinary approach. Women are more likely to be sensitized, with preformed anti-human leukocyte antigens antibodies related to prior pregnancies, posing challenges for their pretransplant and post-transplant management.