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. 2022 Nov;41(11):1611-1616.
doi: 10.1016/j.healun.2022.07.021. Epub 2022 Jul 30.

Attitudes & practices surrounding pregnancy post heart transplant among pediatric providers

Megan M Collins  1 , Zhining Ou  2 , Morgan M Millar  2 , Michelle M Kittleson  3 , Lindsay J May  4 , Michelle S Ploutz  4 , Kimberly M Molina  4 , Katherine G Hayes  5 , Ashwin K Lal  4
Affiliations

Attitudes & practices surrounding pregnancy post heart transplant among pediatric providers

Megan M Collins et al. J Heart Lung Transplant. 2022 Nov.

Abstract

Background: Many pediatric heart transplant (HT) recipients reach adulthood and may be interested in family planning; there is little data regarding safety of pregnancy post HT and clinicians' opinions differ. Pediatric HT clinicians are instrumental in early counseling. Thus, a better understanding of pediatric HT clinicians' practices regarding family planning and how well aligned these practices are with adult transplant centers is essential.

Methods: We conducted a confidential, web-based survey of pediatric HT clinicians in fall 2021. We summarized and compared answers using Fisher's exact test.

Results: The survey was sent to 53 United States-based HT directors and to the International Society for Heart and Lung Transplantation and Pediatric Heart Transplant Society list serves. There were 69 respondents. The majority (77%) of respondents felt pregnancy was feasible in selected or all female HT recipients. Ten respondents reported that their institution had an established policy regarding pregnancy post HT. A majority (77%) of HT clinicians would either use a shared care model or recommend transition to their adult institution if pregnancy occurred, though 74% of respondents were either unaware of their corresponding adult institution's policy (62%) or had a counterpart adult program with a policy against pregnancy post HT (12%).

Conclusions: While many clinicians feel pregnancy is feasible in pediatric HT recipients, there remains significant practice variation. Few pediatric programs have a policy regarding pregnancy post HT. Future efforts to provide consistent messaging between adult and pediatric HT programs regarding the feasibility and care of post HT pregnancy are warranted.

Keywords: heart transplant; organ transplant; pediatrics; pregnancy; pregnancy post transplant.

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Conflict of interest statement

Disclosure statement The authors have no actual or potential conflicts of interest (financial, competitive, or otherwise) to disclose. This investigation was supported by the University of Utah Study Design and Biostatistics Center with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant 8UL1TR000105 (formerly UL1RR025764) and Award Number UL1TR002538. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Figures

Figure 1:
Figure 1:
Pediatric HT clinicians’ opinions regarding pregnancy post HT
Figure 2:
Figure 2:
Pediatric HT clinician’s preference when caring for pregnant HT recipients
Figure 3:
Figure 3:
Pediatric HT clinicians’ familiarity with their adult center’s policy (n=69)
See this image and copyright information in PMC

References

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