POSTTRANSPLANT PREGNANCY

In the past twenty years, the increased number of organ transplant rec ipients and better immunosupressive regims have enhanced transplant su rvival, and several transplant recipients may conceive pregnancy or pa ternity after the graft. There is no French registry of posttransplant pregnancies, but analysis of the international literature reports 230 0 pregnancies after kidney transplantation, 100 pregnancies after hear t and 3 after heart-lung transplantation, 90 pregnancies after liver t ransplantation, Paternity after the graft may occur with no increased incidence of malformations, nor teratogenic and immunosupressive effec ts due to the therapeutic regimen, All pregnancies after transplantati on have to be considered at high risk, underlying the need for simulta neous followup by the gyneco-obstetrical team for the baby and the pre gnancy and by the transplant team for the graft and the mother, Outcom e is generally excellent for the mother and the baby. However, transpl ant recipients with either high blood pressure, diabetes, serum creati nine above 160 mu mol/l or within less than 1 year after the graft sho uld be considered at too high risk to conceive a pregnancy with no del eterious effect on the mother and/or on the foetus.