Pregnancies After Orthotopic Heart Transplantation: A Single-Center Experience.

Background: Patients who underwent orthotopic heart transplantation have improved survival and quality of live. Some of them are women of childbearing age and have a wish to be pregnant. If the decision to have a child is made, the patient needs a multidisciplinary approach.

Material And Methods: We analyzed the whole cohort of patients after orthotopic heart transplantation. From the whole group we extracted women of childbearing age between 16 and 45 years and at least 1 year after transplantation (85 patients). From this group, 8 patients gave birth to children.

Results: No cardiocirculatory problems were observed in the mothers during pregnancy and in follow-ups. Strong changes in immunosuppressive drug levels were observed during and directly after the pregnancies. Two children were born prematurely (at 31 and in 34 weeks of gestation). Two children developed cardiomyopathy (the same as in mother).

Conclusion: The decision of childbearing should be made individually considering each patient's medical history and potential risks connected with the pregnancy. Pregnancy after heart transplantation is relatively safe for the mother. Risk of transmitting cardiomyopathies to the children, especially hypertrophic cardiomyopathy, is high. The patients should be aware of this fact and be carefully counseled preconceptionally.