title: Paternity by cardiac transplant recipients.
abstract: To assess whether children fathered by cardiac transplant recipients are at high risk of teratogenicity, cardiac transplant centers listed with the International Society for Heart and Lung Transplantation were surveyed. Paternities after transplantation by heart (n = 35) and heart-lung (n = 1) allograft recipients have resulted in 42 pregnancies (children's age 3.3 +/- 0.3 years). The fathers' age at conception was < 45 years in 40 (95%) and > 45 years in 2 (5%). Most fathers (86%) were enjoying an active and healthy lifestyle at the time of conception; one (2%) was on dialysis and listed for kidney transplantation due to nephrotic syndrome, 1 (2%) had asthma, 4 (10%) had allograft coronary disease (1 died while waiting for second heart transplant when the child was 2 months old), and 2 (5%) were retransplanted after the pregnancies. Immunosuppressive regimens were reported for 37 paternities; drug protocols at the time of conception were as follows: 25 (60%) CsA/prednisone/AZA, 6 (14%) CsA/prednisone, 4 (10%) CsA/AZA, and 2 (5%) AZA/prednisone. Twenty-six (62%) had received treatment for rejection episodes before conception; seven (17%) had received treatment for rejections since conception. Of the 42 children fathered by these recipients, 3 (7%) were preterm, 1 (2%) had a cleft palate and lip that have subsequently been corrected, 1 (2%) died from interruption of umbilical cord circulation at 24 weeks, and 1 (2%) whose father had familial cardiomyopathy was born with a cardiomyopathy that improved with time. Although the numbers are small, the available data suggest that paternity by cardiac transplant recipients may be safe.
authors.affiliation: Division of Cardiology, University of Utah Health Sciences Center, Salt Lake City.
authors.forename: L E
authors.initials: LE
authors.lastname: Wagoner
authors.forename: D O
authors.initials: DO
authors.lastname: Taylor
authors.forename: G D
authors.initials: GD
authors.lastname: Price
authors.forename: M E
authors.initials: ME
authors.lastname: Hagan
authors.forename: C
authors.initials: C
authors.lastname: Holland
authors.forename: S L
authors.initials: SL
authors.lastname: Olsen
authors.forename: D G
authors.initials: DG
authors.lastname: Renlund
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005260:Female; D005298:Fertility / Q000502:physiology*; D016027:Heart Transplantation / Q000502:physiology*; D016041:Heart-Lung Transplantation / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010334:Paternity; D011247:Pregnancy / Q000706:statistics & numerical data; D012307:Risk Factors; D011795:Surveys and Questionnaires