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Am J Transplant. 2018 May;18(5):1068-1076. doi: 10.1111/ajt.14697. Epub 2018 Mar 30.

Reproductive health in women following abdominal organ transplant.

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Department of Medicine, Division of Gastroenterology and Hepatology, University of California, San Francisco, San Francisco, CA, USA.
Department of Renal Medicine, Division of Transplantation and Mucosal Biology, King's College London, London, UK.
Gift of Life Institute, Transplant Pregnancy Registry (TPR) International, Philadelphia, PA, USA.
Lehigh Valley Health Network, Allentown, PA, USA.
University of South Florida Morsani College of Medicine, Tampa, FL, USA.


Fertility is commonly impaired in women with end-stage kidney and liver disease, although most women will have restoration of fertility within 1 year of transplant. Family planning is therefore critical to discuss with reproductive-aged transplant recipients in the early posttransplant period, in order to ensure timely initiation of contraception, and optimal timing for conception. For women seeking pregnancy, the risks to the mother, graft, and baby should be discussed, including evaluation of immunosuppression safety and potential for adjusting medications prior to conception. With an increasing number of transplant patients now breastfeeding, immunosuppression safety in lactation continues to carry great importance.


clinical research/practice; kidney disease; kidney transplantation/nephrology; liver disease; liver transplantation/hepatology; obstetrics and gynecology; patient safety; pregnancy; reproductive biology

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