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

Abstract

Vincent T. Armenti, MD, PhD, Professor of Surgery, Temple University School of Medicine, Abdominal Transplant Program, Philadelphia, Pennsylvania Phyllis August, MD, MPH, Professor of Medicine, Division of Hypertension, Weill Medical College of Cornell University, New York, New York Lisa A. Coscia, RN, BSN, CCTC, Research Coordinator, National Transplantation Pregnancy Registry, Temple University School of Medicine, Philadelphia, Pennsylvania Connie L. Davis, MD, Professor of Medicine, Div. of Nephrology, Univ. of Washington, Box 356174, 1959 NE Pacific St., Seattle, WA 98195 John M Davison MD, Professor of Obstetric Medicine, Consultant Obstetrician, University of Newcastle upon Tyne, School of Surgical and Reproductive Sciences, Faculty of Medical Sciences, William Leech Building, Newcastle upon Tyne NE2 4HH, UK Thomas Easterling, MD, Professor, Maternal Fetal Medicine, University of Washington, Box 356460, 1959 ND Pacific Street, Seattle, WA 98195 Jan M. Friedman, MD, PhD, Professor of Medical Genetics, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada V6T 1Z3 Susan Hou, MD, Professor of Medicine, Department of Medicine, Loyola University Medical Center, Maywood, IL Janet Karlix, Pharm, D, FCCP, Associate Professor, College of Pharmacy, University of Florida, Gainesville, FL Kathleen D, Lake, Pharm.D., BCPS, FCCP, Adjunct Professor, University of Michigan Medical School and College of Pharmacy, Ann Arbor, MI, Medical Transplant Liaison, Roche Laboratories, Nutley, NJ Marshall Lindheimer, MD, Professor Emeritus, Departments of Obstetrics & Gynecology, and Medicine,, University of Chicago, Chicago, Ill Arthur J. Matas, MD, Professor of Surgery, University of Minnesota, Department of Surgery, University of Minnesota Hospital, Minneapolis, MN Michael J. Moritz, MD, Professor of Surgery, Drexel University College of Medicine, Director, Abdominal Transplantation, Hahnemann University Hospital, Philadelphia, Pennsylvania Caroline A. Riely, MD, Professor, Medicine and Pediatrics, Chief of Hepatology Section, Gastroenterology Division, University of Tennessee Science Center Lainie Friedman Ross, MD, PhD, Associate Director, MacLean Center for Clinical Medical Ethics, Associate Professor, University of Chicago, Department of Pediatrics, Chicago, Illinois James R. Scott, MD, Professor and Chair Emeritus, Department of Obstetrics and Gynecology, University of Utah Medical Center, Salt Lake City, Utah Lynne E. Wagoner, MD, Director, Heart Failure and Transplantation, Associate Professor, Division of Cardiology, University of Cincinnati, Cincinnati, Ohio Lucile Wrenshall, MD, PhD, Associate Professor, Department of Surgery, Division of Transplantation, University of Nebraska Medical Center, Omaha, NE And the consensus committee organizers of the Women's Health Committee of the American Society of Transplantation: Patricia L. Adams, MD, Professor of Medicine, Associate Dean for Student Services, Wake Forest University School of Medicine, Med Center Blvd, Winston Salem, NC 27157 Ginny L. Bumgardner MD, PhD, Associate Professor of Surgery, Division of Transplantation, The Ohio State University Med. Center, Columbus, Ohio Richard N. Fine, MD, Professor and Chairman, State U. of NY, Health Science Centre T-11 020, Stony Brook, NY 11794–8111 Simin Goral, MD, Associate Professor of Medicine, Renal Electrolyte and Hypertension Division, University of Pennsylvania Health System, Philadelphia, Pennsylvania Sheri M. Krams, PhD, Associate Professor, Department of Surgery/Transplant, Stanford University School of Medicine, 1201 Welch Road, MSLS P313, Stanford, CA 94305–5492 Olivia M. Martinez, PhD, Associate Professor, Stanford University School of Medicine, Dept of Surgery, 1201 Welch Road, MSLS P312, Stanford, CA 94305–5492 Nina Tolkoff-Rubin, MD, Director of Hemodialysis and CAPD Units, Medical Director for Renal Transplantation, Massachusetts General Hospital, Associate Professor of Medicine, Harvard Medical School, Boston, Massachusetts Martha Pavlakis, MD, Assistant Professor of Medicine, Harvard Medical School, Medical Director, Kidney and Pancreas Transplantation, Beth Israel Deaconess Medical Center, The Transplant Center LMOB 7th floor, 110 Francis Street, Boston, MA 02215 Velma Scantlebury, MD, Professor of Surgery, Chief, Division of Transplantation, Assistant Dean for Community Education, University of South Alabama, 2451 Fillingim Street, 10th Flr, Suite F, Mobile, Alabama 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