As a transplant coordinator, I have been asked very serious questions about pregnancy and sexual activity. After a careful search of literature, I was both very encouraged by what I found, and I also realized there were many things that transplant patients should know about pregnancy, family planning and general health concerns. Here are some questions that most patients were concerned about:
Can I become pregnant after transplant?
Yes, it is possible to become pregnant very soon after a successful transplant. It was surprising, or not so surprising, that almost half of the all the births that occurred in transplant recipients, were unplanned pregnancies. This may be explained by the fact that normal periods and increased libido may occur in as little as one month after a successful organ transplant. For this reason, it is important to communicate with your doctor about your periods and feelings about the return to sexual activity.
What about male transplant recipients?
For, men, fertility may be decreased in the first 6 months after transplant when most transplant recipients are on high doses of anti-rejection drugs. However, fertility returns to normal as anti-rejection drugs are decreased to a maintenance level and as the transplanted organ begins to function. Prematurity and birth defects of children are similar to that of the general population.
How long should I wait after my transplant to become pregnant?
It is recommended to wait at least one to two years after a transplant to conceive, when high-doses of anti-rejection drugs are usually at maintenance levels. According to one study of post-transplant recipients, most of whom were less 21 years of age at the time of transplant, the great majority of pregnancies resulted in a healthy baby later on. This is good news for the overall population of transplant recipients, however, individuals should consult their transplant doctor if they are planning a pregnancy or if they have missed a regular menstrual cycle. It is very important to be followed by doctors during pregnancy to maintain a well-controlled blood pressure and blood sugar for the best outcome.
Is pregnancy safe for female transplant recipients?
Safety of pregnancy in transplant recipients involves three outcomes: mother, baby, and the transplanted organ. In the majority of transplant recipients, a healthy mother with stable transplanted organ function did not have excessive problems during pregnancy or delivery. A small percentage of women will develop rejection or graft dysfunction that might be related to pregnancy; however, most healthy mothers will have a good outcome. There were slightly higher rejection rates for those who became pregnant in the first six months after a transplant. As for the safety of the baby, there is a 3 times greater risk of prematurity (born less than 37 weeks) and low-birth weight (less than 5 pounds at birth), but most babies were born relatively healthy. The amount of babies born with birth defects was similar to the general population. Babies generally grow and develop normally.
 | What is the best way to get information on pregnancy outcomes of transplant recipients? Your transplant team can supply the best and most current information about pregnancy. It is encouraged that transplant recipients and the transplant team address these issues as part of routine clinic visits. |
Currently most of the data about pregnancy and transplant is given voluntarily by other transplant recipients. Transplant recipients who become pregnant or have attempted pregnancy, both male and female, are encouraged to participate in a confidential information collecting study by Thomas Jefferson University called the National Transplant Pregnancy Registry.
The registry has been collecting data since 1991 and has received thousands of reports. To participate, a one-page survey can be obtained from your transplant coordinator, or on the web: www.tju.edu/ntpr/enroll.cfm. Most of the information provided in this article was from the registry.
In conclusion, transplant recipients are able to become pregnant and have successfully carried pregnancies in the past. The risk is generally low for complications, and the best outcomes are generally related to healthy mothers or fathers and stable transplanted organ function at the time of pregnancy.
This article completes one of a three-part series of articles related to family planning of the transplant recipient. Look for future articles addressing family planning issues and reproductive health maintenance in upcoming issues.
- Carly Bhave, R.N., M.S., C.R.N.P.
