title: Successful full-term pregnancy in a patient three and a half years after a heart transplant.
abstract: The patient is a 28 year old woman who received a heart transplant in 1992 secondary to hypertrophic cardiomyopathy with unremarkable post-operative course. In the period immediately post transplantation the patient was on a four-drug immunosuppressive regimen which was subsequently changed to standard three-agent therapy. This therapy was continued until the patient became pregnant. In the first trimester only Cyclosporine (CsA) was used, and thereafter, the patient was continued on the previous three agent regimen. Toward the end of pregnancy a rise in systolic pressure was observed, but the child was delivered by spontaneous vaginal delivery without complications in the 38th week of pregnancy. The newborn weighed 3320 g and was in good health. A sharp fall in the newborn CsA blood levels was observed post delivery reaching zero level on the third day of life. At the present time, both mother and baby are in good health, 6 weeks after delivery.
authors.affiliation: Cardiac and Vascular Surgery Dept, Collegium Medicum Jagiellonian University, Kraków, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Dziatkowiak
authors.forename: Z
authors.initials: Z
authors.lastname: Zdebski
authors.forename: W
authors.initials: W
authors.lastname: Tracz
authors.forename: W
authors.initials: W
authors.lastname: Piwowarska
authors.forename: M
authors.initials: M
authors.lastname: Garlicki
authors.forename: B
authors.initials: B
authors.lastname: Kapelak
authors.forename: T
authors.initials: T
authors.lastname: Tomaszczyk
authors.forename: M
authors.initials: M
authors.lastname: Migdał
authors.forename: T
authors.initials: T
authors.lastname: Wysocka
authors.forename: J
authors.initials: J
authors.lastname: Sadowski
authors.forename: R
authors.initials: R
authors.lastname: Pfitzner
authors.forename: J
authors.initials: J
authors.lastname: Nessler
authors.forename: E
authors.initials: E
authors.lastname: Pietrzyk
authors.forename: S
authors.initials: S
authors.lastname: Wójcik
authors.forename: P
authors.initials: P
authors.lastname: Rudziński
authors.forename: A
authors.initials: A
authors.lastname: Lesniak
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery; D016572:Cyclosporine / Q000627:therapeutic use; D036861:Delivery, Obstetric; D004359:Drug Therapy, Combination; D005260:Female; D016027:Heart Transplantation / Q000276:immunology / Q000502:physiology; D006439:Hemodynamics; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine