From American Journal of Transplantation

Reproduction and Transplantation: Report on the AST Consensus Conference on
Reproductive Issues and Transplantation

Posted 07/01/2005
Dianne B. McKay; Michelle A. Josephson
Abstract and IntroductionAbstract
It has been almost 50 years since the first child was born to a female
transplant recipient. Since that time pregnancy has become common after
transplantation, but physicians have been left to rely on case reports, small
series and data from voluntary registries to guide the care of their patients.
Many uncertainties exist including the risks that pregnancy presents to the
graft, the patient herself, and the long-term risks to the fetus. It is also
unclear how to best modify immunosuppressive agents or treat rejection during
pregnancy, especially in light of newer agents available where pregnancy safety
has not been established.

To begin to address uncertainties and define clinical practice guidelines for
the transplant physician and obstetrical caregivers, a consensus conference was
held in Bethesda, Md. The conferees summarized both what is known and important
gaps in our knowledge. They also identified key areas of agreement, and posed a
number of critical questions, the resolution of which is necessary in order to
establish evidence-based guidelines. The manuscript summarizes the deliberations
and conclusions of the conference as well as specific recommendations based on
current knowledge in the field.
Introduction
To better understand how to advise and manage pregnant transplant recipients, a
Consensus Conference was organized by the Women's Health Committee of the
American Society of Transplantation, and held March 1 – 2, 2003, in Bethesda,
Md. Primary goals included developing clinical practice guidelines for both
transplant physicians and obstetrical caregivers, identification of areas most
needing study, encouraging universal use of established registries, and
advocating for prospective observational studies. Table 1 highlights the
Consensus reached at this conference.





Sandra Tara Balduf (Ane)

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