title: Reproduction and transplantation: report on the AST Consensus Conference on Reproductive Issues and Transplantation.
abstract: It has been almost 50 years since the first child was born to a female transplant recipient. Since that time pregnancy has become common after transplantation, but physicians have been left to rely on case reports, small series and data from voluntary registries to guide the care of their patients. Many uncertainties exist including the risks that pregnancy presents to the graft, the patient herself, and the long-term risks to the fetus. It is also unclear how to best modify immunosuppressive agents or treat rejection during pregnancy, especially in light of newer agents available where pregnancy safety has not been established. To begin to address uncertainties and define clinical practice guidelines for the transplant physician and obstetrical caregivers, a consensus conference was held in Bethesda, Md. The conferees summarized both what is known and important gaps in our knowledge. They also identified key areas of agreement, and posed a number of critical questions, the resolution of which is necessary in order to establish evidence-based guidelines. The manuscript summarizes the deliberations and conclusions of the conference as well as specific recommendations based on current knowledge in the field.
authors.affiliation: Transplantation Medicine, The Scripps Clinic/Scripps Green Hospital, The Scripps Research Institute, La Jolla, California, USA. dmckay@scripps.edu
authors.forename: Dianne B
authors.initials: DB
authors.lastname: McKay
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Josephson
authors.forename: Vincent T
authors.initials: VT
authors.lastname: Armenti
authors.forename: Phyllis
authors.initials: P
authors.lastname: August
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Coscia
authors.forename: Connie L
authors.initials: CL
authors.lastname: Davis
authors.forename: John M
authors.initials: JM
authors.lastname: Davison
authors.forename: Thomas
authors.initials: T
authors.lastname: Easterling
authors.forename: Jan E
authors.initials: JE
authors.lastname: Friedman
authors.forename: Susan
authors.initials: S
authors.lastname: Hou
authors.forename: Janet
authors.initials: J
authors.lastname: Karlix
authors.forename: Kathleen D
authors.initials: KD
authors.lastname: Lake
authors.forename: Marshall
authors.initials: M
authors.lastname: Lindheimer
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Matas
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Moritz
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Riely
authors.forename: Lainie Friedman
authors.initials: LF
authors.lastname: Ross
authors.forename: James R
authors.initials: JR
authors.lastname: Scott
authors.forename: Lynne E
authors.initials: LE
authors.lastname: Wagoner
authors.forename: Lucile
authors.initials: L
authors.lastname: Wrenshall
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Adams
authors.forename: Ginny L
authors.initials: GL
authors.lastname: Bumgardner
authors.forename: Richard N
authors.initials: RN
authors.lastname: Fine
authors.forename: Simin
authors.initials: S
authors.lastname: Goral
authors.forename: Sheri M
authors.initials: SM
authors.lastname: Krams
authors.forename: Olivia M
authors.initials: OM
authors.lastname: Martinez
authors.forename: Nina
authors.initials: N
authors.lastname: Tolkoff-Rubin
authors.forename: Martha
authors.initials: M
authors.lastname: Pavlakis
authors.forename: Velma
authors.initials: V
authors.lastname: Scantlebury
mesh_terms: D005260:Female; D006801:Humans; D016377:Organ Transplantation; D011247:Pregnancy; D012098:Reproduction