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Multicenter Study
. 2024 Aug;17(8):e011741.
doi: 10.1161/CIRCHEARTFAILURE.124.011741. Epub 2024 Aug 1.

Patient Perceptions and Knowledge Surrounding Pregnancy After Heart Transplantation: A Multicenter Study

Ersilia M DeFilippis #  1 , Elena M Donald #  1 , Karlee Hoffman  2 , Karen Flores Rosario  3 , Richa Agarwal  3 , Hilary Shapiro  4 , Kimberly N Hong  4 , Kiran K Khush  5 , Lynn Punnoose  6 , Michelle M Kittleson  7
Affiliations
Multicenter Study

Patient Perceptions and Knowledge Surrounding Pregnancy After Heart Transplantation: A Multicenter Study

Ersilia M DeFilippis et al. Circ Heart Fail. 2024 Aug.

Abstract

Background: More women of childbearing age are surviving after heart transplantation (HT), many of whom have a desire to become pregnant. Limited data exist evaluating patients' perspectives, receipt of counseling, and knowledge surrounding contraception, pregnancy, breastfeeding, and medication safety after HT.

Methods: We conducted a voluntary, confidential, web-based cross-sectional survey of women who were childbearing age (defined as 18-45 years) at the time of HT. Transplants occurred between January 2005 and January 2020. Surveys were conducted across 6 high-volume HT centers in the United States.

Results: There were 64 responses from women who were of childbearing age at the time of HT. Twenty-five women (39.1%) were pregnant before HT, and 6 (9.4%) women reported at least 1 pregnancy post-transplant. Fifty-three percent (n=34) reported they did not receive enough information on post-HT pregnancy before listing for HT, and 26% (n=16) did not discuss their ability to become pregnant with their care team before proceeding with HT. Following HT, 44% (n=28) still felt that they had not received enough information regarding pregnancy. The majority of women (n=49, 77%) had discussed contraception to prevent unplanned pregnancy with their transplant team. Twenty percent (n=13) reported that pregnancy was never safe after transplantation based on the information they had received from their transplant providers.

Conclusions: Many women feel they are not receiving adequate counseling with regard to posttransplant reproductive health. This survey highlights an opportunity to improve both provider education and patient communication to better support women with HT desiring posttransplant pregnancy.

Keywords: contraception; heart transplantation; immunosuppression; pregnancy; women’s health.

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Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.. Medication Safety Awareness
Bar graph showing answers to the question: “To the best of your knowledge, check off all medications that are unsafe during pregnancy.” An individual respondent could select multiple answers. ACE = angiotensin converting-enzyme; CNI = calcineurin inhibitor
Figure 2.
Figure 2.. Contraception Use Following Heart Transplantation
Forty-two of the 64 (66%) respondents reported using at least one form of contraception post-HT. The distribution of use of different types of contraceptive devices is shown.
Figure 3.
Figure 3.
Future Areas of Education and Reproductive Counseling for Heart Transplant Recipients
See this image and copyright information in PMC

Comment in

References

    1. Khush KK, Cherikh WS, Chambers DC, Goldfarb S, Hayes D Jr., Kucheryavaya AY, Levvey BJ, Meiser B, Rossano JW, Stehlik J, International Society for H and Lung T. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-fifth Adult Heart Transplantation Report-2018; Focus Theme: Multiorgan Transplantation. J Heart Lung Transplant. 2018;37:1155–1168. - PubMed
    1. Costanzo MR, Dipchand A, Starling R, Anderson A, Chan M, Desai S, Fedson S, Fisher P, Gonzales-Stawinski G, Martinelli L, McGiffin D, Smith J, Taylor D, Meiser B, Webber S, Baran D, Carboni M, Dengler T, Feldman D, Frigerio M, Kfoury A, Kim D, Kobashigawa J, Shullo M, Stehlik J, Teuteberg J, Uber P, Zuckermann A, Hunt S, Burch M, Bhat G, Canter C, Chinnock R, Crespo-Leiro M, Delgado R, Dobbels F, Grady K, Kao W, Lamour J, Parry G, Patel J, Pini D, Towbin J, Wolfel G, Delgado D, Eisen H, Goldberg L, Hosenpud J, Johnson M, Keogh A, Lewis C, O’Connell J, Rogers J, Ross H, Russell S, Vanhaecke J, International Society of H and Lung Transplantation G. The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients. J Heart Lung Transplant. 2010;29:914–56. - PubMed
    1. McKay DB, Josephson MA, Armenti VT, August P, Coscia LA, Davis CL, Davison JM, Easterling T, Friedman JE, Hou S, Karlix J, Lake KD, Lindheimer M, Matas AJ, Moritz MJ, Riely CA, Ross LF, Scott JR, Wagoner LE, Wrenshall L, Adams PL, Bumgardner GL, Fine RN, Goral S, Krams SM, Martinez OM, Tolkoff-Rubin N, Pavlakis M, Scantlebury V and Women’s Health Committee of the American Society of T. Reproduction and transplantation: report on the AST Consensus Conference on Reproductive Issues and Transplantation. Am J Transplant. 2005;5:1592–9. - PubMed
    1. Punnoose LR, Coscia LA, Armenti DP, Constantinescu S and Moritz MJ. Pregnancy outcomes in heart transplant recipients. J Heart Lung Transplant. 2020;39:473–480. - PubMed
    1. Acuna S, Zaffar N, Dong S, Ross H and D’Souza R. Pregnancy outcomes in women with cardiothoracic transplants: A Systematic review and meta-analysis. J Heart Lung Transplant. 2020;39:93–102. - PubMed

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