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Pregnancy after lung transplantation

Dear expert team,
I have been lung transplanted due to CF 6 years ago. As a am living in a stable relationship, I am feeling again the desire to have a baby by the course of time. I do not have any children yet and I am in a good condition. I did not have any rejections for many years and I had only 3 rejections altogether in the whole time. Furthermore there had not been any complications either. Is it possible for me to give birth to a baby? I would strongly desire that. In case you do not know anything about this, I would appreciate if you could give me an advice to whom I can ask this question.
Best regards,

Thank you for your question relating to pregnancy in ladies with CF following lung transplantation. Firstly, it is great that you are doing so well following transplantation and it is very normal to be considering pregnancy in this situation. There is quite a lot of information in this area relating to women who have become pregnant following transplantation of a range of organs. The most common situation is pregnancy following kidney transplantation but women hav e had successful pregnancies after liver, heart and lung transplants. Taking all of these groups there are around 14,000 pregnancies recorded and there is a a generally positive picture from this information. Here is some information to consider:

1. Women following transplantation have the same likelihood of achieving pregnancy as any other women.

2. It is recommended to wait at least one and possible 2 years after transplantation before becoming pregnant. This clearly is not an issue in your situation as it is 6 years from your transplant.

3. There are a number of complications which you should consider which are increased in women who have had a transplant and become pregnant.
a) There is an increase in organ rejection. This is a little hard to quantify but probably is around 15-20% for lungs.
b) The drugs used tend to cause problems with high blood pressure and kidney function. Blood pressure is a problem for many women during pregnancy and the drugs immunosuppressive such as cyclosorine add to the problem in women who have had transplantation The implications of this are that you will need careful monitoring during pregnancy, particularly with regard to blood pressure. High blood pressure can lead to a condition called pre-eclampsia which is associated with some problems for mum and baby, although in most cases can be treated.
c) Overall babies to mums who have had organ transplant are premature and often born about 35 weeks rather than 39 – 40 weeks. Again this can present some challenges to mum and baby.

4. There are concerns about the effect of some of the drugs on the developing baby and these should be discussed directly with your transplant team. There is some risk though overall the experience is that there have been very few foetal problems relating to the drug treatments used. However there may need to be some adjustments of your current treatment.

5. it is important to consider the long term issues of child care if you become ill due to rejection.

In summary, having a baby after you have had a lung transplant is possible but it brings with it some extra complications and challenges. It is important that you and your partner think through and discuss in detail with your transplant consultant and CF consultant.


Pregnancy in Recipients of Solid Organs — Effects on Mother and Child
D. B. McKay and M. A. Josephson – NEJM 2006, 354;1281

Best regards
Prof. Stuart Elborn

28th of April 2008: After a discussions during the 2nd Quality Round Table in Prague the answer was rewritten by Prof. Stuart Elborn and published above.