Review

. 2025 Sep 1;109(9):1483-1494.

doi: 10.1097/TP.0000000000005341. Epub 2025 Mar 13.

Pregnancy After Solid Organ Transplantation: Review of the Evidence and Recommendations

Goni Katz-Greenberg¹, Yalda Afshar², Julie Bonn³, Jillian Casale⁴, Serban Constantinescu^{5

6}, Ersilia M DeFilippis⁷, Roshan P George⁸, Ana Iltis⁹, Shilpanjali Jesudason¹⁰, Michelle Kittleson¹¹, Deborah J Levine¹², Michael J Moritz^{6

13}, Monika Sarkar¹⁴, Silvi Shah¹⁵, Kimberly Uccellini¹⁶, Lisa A Coscia⁶, Ana P Rossi¹⁷; American Society of Transplantation Women’s Health Community of Practice Reproductive Health, Contraception and Pregnancy after Transplantation and Living Donation Controversies Conference Participants

Collaborators, Affiliations

Collaborators

American Society of Transplantation Women’s Health Community of Practice Reproductive Health, Contraception and Pregnancy after Transplantation and Living Donation Controversies Conference Participants:
Yalda Afshar¹⁸, Julie Bonn¹⁹, Carla Brady²⁰, Jennifer Byrns²¹, Jillian P Casale²², Serban Constantinescu²³, Lisa Coscia²⁴, Ersilia DeFilippis²⁵, Christina Teeter Doligalski²⁶, Lauren Feld²⁷, Roshan George²⁸, Aviva Goldberg²⁹, Ana S Iltis³⁰, Roxanna Irani¹⁸, Shilpanjali Jesudason³¹, Goni Katz-Greenberg²⁰, Michelle M Kittleson³², Krista L Lentine³³, Deborah Levine³⁴, Frederick L Licciardi³⁵, Arthur J Matas³⁶, Michael J Moritz³⁷, Kathleen E O'Neill³⁸, Swati Rao³⁹, Ana P Rossi⁴⁰, Monika Sarkar⁴¹, Silvi Shah⁴², Alexandra Shingina⁴³, Ms Kimberly Uccellini⁴⁴

Affiliations

¹ Department of Medicine, Division of Nephrology, Duke University Medical Center, Durham, NC.
² Division of Maternal Fetal Medicine, University of California Los Angeles, Los Angeles, CA.
³ Department of Pediatrics, Division of Gastroenterology, University of Cincinnati College of Medicine, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
⁴ Department of Pharmacy, Cooperman Barnabas Medical Center, Livingston, NJ.
⁵ Department of Medicine, Section of Nephrology, Hypertension and Kidney Transplantation, Lewis Katz School of Medicine, Temple University, Philadelphia, PA.
⁶ Transplant Pregnancy Registry International, Philadelphia, PA.
⁷ Division of Cardiology, Columbia University Irving Medical Center, New York, NY.
⁸ Division of Pediatric Nephrology, Emory University and Children's Healthcare of Atlanta, Atlanta, GA.
⁹ Center for Bioethics, Health, and Society, Wake Forest University, Winston-Salem, NC.
¹⁰ Department of Nephrology, Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital and University of Adelaide, Adelaide, SA, Australia.
¹¹ Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA.
¹² Department of Pulmonology, Stanford University, Stanford, CA.
¹³ Gift of Life Donor Program, Philadelphia, PA.
¹⁴ Division of Hepatology, University of California San Francisco, San Francisco, CA.
¹⁵ Division of Nephrology and Hypertension, University of Cincinnati, Cincinnati, OH.
¹⁶ United Network of Organ Sharing, Richmond, VA.
¹⁷ Piedmont Transplant Institute, Atlanta, GA.
¹⁸ University of California Los Angeles.
¹⁹ Cincinnati Children's Hospital Medical Center.
²⁰ Duke University Medical Center.
²¹ Duke University Hospital.
²² Cooperman Barnabas Medical Center.
²³ Temple University.
²⁴ Transplant Pregnancy Registry International.
²⁵ Columbia University Irving Medical Center.
²⁶ University of North Carolina.
²⁷ University of Massachusetts.
²⁸ Emory University.
²⁹ University of Manitoba.
³⁰ Wake Forest University.
³¹ Royal Adelaide Hospital and University of Adelaide.
³² Cedars-Sinai.
³³ Saint Louis University School of Medicine.
³⁴ Stanford University.
³⁵ NYU Langone Health.
³⁶ University of Minnesota.
³⁷ Gift of Life Institute, Transplant Pregnancy Registry International.
³⁸ Penn Medicine.
³⁹ University of Virginia.
⁴⁰ Piedmont Transplant Institute.
⁴¹ University of California San Francisco.
⁴² University of Cincinnati.
⁴³ Vanderbilt University Medical Center.
⁴⁴ United Network of Organ Sharing.

PMID: 40838865
PMCID: PMC12354071
DOI: 10.1097/TP.0000000000005341

Review

Pregnancy After Solid Organ Transplantation: Review of the Evidence and Recommendations

Goni Katz-Greenberg et al. Transplantation. 2025.

. 2025 Sep 1;109(9):1483-1494.

doi: 10.1097/TP.0000000000005341. Epub 2025 Mar 13.

Authors

Collaborators

American Society of Transplantation Women’s Health Community of Practice Reproductive Health, Contraception and Pregnancy after Transplantation and Living Donation Controversies Conference Participants:
Yalda Afshar¹⁸, Julie Bonn¹⁹, Carla Brady²⁰, Jennifer Byrns²¹, Jillian P Casale²², Serban Constantinescu²³, Lisa Coscia²⁴, Ersilia DeFilippis²⁵, Christina Teeter Doligalski²⁶, Lauren Feld²⁷, Roshan George²⁸, Aviva Goldberg²⁹, Ana S Iltis³⁰, Roxanna Irani¹⁸, Shilpanjali Jesudason³¹, Goni Katz-Greenberg²⁰, Michelle M Kittleson³², Krista L Lentine³³, Deborah Levine³⁴, Frederick L Licciardi³⁵, Arthur J Matas³⁶, Michael J Moritz³⁷, Kathleen E O'Neill³⁸, Swati Rao³⁹, Ana P Rossi⁴⁰, Monika Sarkar⁴¹, Silvi Shah⁴², Alexandra Shingina⁴³, Ms Kimberly Uccellini⁴⁴

Affiliations

¹ Department of Medicine, Division of Nephrology, Duke University Medical Center, Durham, NC.
² Division of Maternal Fetal Medicine, University of California Los Angeles, Los Angeles, CA.
³ Department of Pediatrics, Division of Gastroenterology, University of Cincinnati College of Medicine, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
⁴ Department of Pharmacy, Cooperman Barnabas Medical Center, Livingston, NJ.
⁵ Department of Medicine, Section of Nephrology, Hypertension and Kidney Transplantation, Lewis Katz School of Medicine, Temple University, Philadelphia, PA.
⁶ Transplant Pregnancy Registry International, Philadelphia, PA.
⁷ Division of Cardiology, Columbia University Irving Medical Center, New York, NY.
⁸ Division of Pediatric Nephrology, Emory University and Children's Healthcare of Atlanta, Atlanta, GA.
⁹ Center for Bioethics, Health, and Society, Wake Forest University, Winston-Salem, NC.
¹⁰ Department of Nephrology, Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital and University of Adelaide, Adelaide, SA, Australia.
¹¹ Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA.
¹² Department of Pulmonology, Stanford University, Stanford, CA.
¹³ Gift of Life Donor Program, Philadelphia, PA.
¹⁴ Division of Hepatology, University of California San Francisco, San Francisco, CA.
¹⁵ Division of Nephrology and Hypertension, University of Cincinnati, Cincinnati, OH.
¹⁶ United Network of Organ Sharing, Richmond, VA.
¹⁷ Piedmont Transplant Institute, Atlanta, GA.
¹⁸ University of California Los Angeles.
¹⁹ Cincinnati Children's Hospital Medical Center.
²⁰ Duke University Medical Center.
²¹ Duke University Hospital.
²² Cooperman Barnabas Medical Center.
²³ Temple University.
²⁴ Transplant Pregnancy Registry International.
²⁵ Columbia University Irving Medical Center.
²⁶ University of North Carolina.
²⁷ University of Massachusetts.
²⁸ Emory University.
²⁹ University of Manitoba.
³⁰ Wake Forest University.
³¹ Royal Adelaide Hospital and University of Adelaide.
³² Cedars-Sinai.
³³ Saint Louis University School of Medicine.
³⁴ Stanford University.
³⁵ NYU Langone Health.
³⁶ University of Minnesota.
³⁷ Gift of Life Institute, Transplant Pregnancy Registry International.
³⁸ Penn Medicine.
³⁹ University of Virginia.
⁴⁰ Piedmont Transplant Institute.
⁴¹ University of California San Francisco.
⁴² University of Cincinnati.
⁴³ Vanderbilt University Medical Center.
⁴⁴ United Network of Organ Sharing.

PMID: 40838865
PMCID: PMC12354071
DOI: 10.1097/TP.0000000000005341

Abstract

Solid organ transplantation (SOT) offers people with end-stage organ disease an increased quality of life, which includes the return of fertility and the potential for pregnancy. Although the number of pregnancies has increased, definitive recommendations have been lacking. To address reproductive health in SOT recipients, the American Society of Transplantation Women's Health Community of Practice held a virtual Controversies Conference with subject matter experts gathered to discuss topics of contraception, immunosuppression, and pregnancy in SOT recipients and pregnancy post-living donation. This publication is a synthesis of expert guidance and available data regarding pregnancy management and outcomes after all types of SOTs.

PubMed Disclaimer

Figures

**FIGURE 1.**
Prepregnancy guidance. CAV, cardiac allograft vasculopathy; CHD, chronic heart disease; CKD, chronic kidney disease; CLAD, chronic lung allograft dysfunction; CMV, cytomegalovirus; DSA, donor-specific antibody; eGFR, estimated glomerular filtration rate; EMB, endomyocardial biopsy; HT, heart transplant; LFT, liver function test; LuTR, lung transplant recipient; PPCM, postpartum cardiomyopathy; RHC, right heart catheterization.

**FIGURE 2.**
Pregnancy outcomes per transplanted organ.

See this image and copyright information in PMC

References

1. Murray JE, Reid DE, Harrison JH, et al. Successful pregnancies after human renal transplantation. N Engl J Med. 1963;269:341–343. - PubMed
1. Shah S, Venkatesan RL, Gupta A, et al. Pregnancy outcomes in women with kidney transplant: metaanalysis and systematic review. BMC Nephrol. 2019;20:24. - PMC - PubMed
1. Sarkar M, Bramham K, Moritz MJ, et al. Reproductive health in women following abdominal organ transplant. Am J Transplant. 2018;18:1068–1076. - PMC - PubMed
1. Valentin N, Guerrido I, Rozenshteyn F, et al. Pregnancy outcomes after liver transplantation: a systematic review and meta-analysis. Am J Gastroenterol. 2021;116:491–504. - PubMed
1. Punnoose LR, Coscia LA, Armenti DP, et al. Pregnancy outcomes in heart transplant recipients. J Heart Lung Transplant. 2020;39:473–480. - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions

Grants and funding

K23 HL151816/HL/NHLBI NIH HHS/United States

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Pregnancy After Solid Organ Transplantation: Review of the Evidence and Recommendations

Collaborators

Affiliations

Pregnancy After Solid Organ Transplantation: Review of the Evidence and Recommendations

Authors

Collaborators

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical