Contraception Use Differs Across Solid Organ Transplant Types Among Women Transplanted in Reproductive Age

Area of Science:

• Transplant medicine
• Reproductive health
• Pharmacovigilance

Background:

• Solid organ transplant (SOT) recipients are a growing population of reproductive age.
• Limited comparative data exist on contraception use across different organ transplant types.

Purpose of the Study:

• To assess contraception uptake and patterns after SOT.
• To compare clinical outcomes associated with different contraceptive methods post-SOT.

Main Methods:

• Retrospective cohort study of 10,155 women aged 18-45 undergoing first-time liver, kidney, heart, or lung transplant (2015-2025) using TriNetX.
• Assessed contraception uptake within two years post-transplant by organ type.
• Compared clinical outcomes (osteoporosis, thromboembolism, graft rejection) by contraception type.

Main Results:

• Only 19.9% of SOT recipients used contraception within two years.
• Heart transplant recipients had the highest uptake (27.3%), liver transplant recipients the lowest (16.8%).
• Depot medroxyprogesterone acetate (DMPA) was associated with increased osteoporosis, hypertension, thrombosis, and graft rejection; estradiol-containing agents were not.

Conclusions:

• Contraception use is uncommon post-SOT, with low rates of highly effective methods, especially after liver and kidney transplants.
• Higher switching rates and adverse associations with DMPA highlight the need for organ-tailored contraceptive counseling and careful method selection.