Anesthetic Considerations for the Parturient After Solid Organ Transplantation.
Over the past 40 years, the success of organ transplantation has increased such that female solid organ transplant recipients are able to conceive and carry pregnancies successfully to term. Anesthesiologists are faced with the challenge of providing anesthesia care to these high-risk obstetric patients in the peripartum period. Anesthetic considerations include the effects of the physiologic changes of pregnancy on the transplanted organ, graft function in the peripartum period, and the maternal side effects and drug interactions of immunosuppressive agents. These women are at an increased risk of comorbidities and obstetric complications. Anesthetic management should consider the important task of protecting graft function. Optimal care of a woman with a transplanted solid organ involves management by a multidisciplinary team. In this focused review article, we review the anesthetic management of pregnant patients with solid organ transplants of the kidney, liver, heart, or lung.
From the Departments of *Clinical Anesthesiology and †Obstetrics and Gynecology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida.
Daria M
DM
Moaveni
Jennifer H
JH
Cohn
Katherine G
KG
Hoctor
Ryan E
RE
Longman
J Sudharma
JS
Ranasinghe
D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D015897:Comorbidity; D004347:Drug Interactions; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D050498:Live Birth; D016377:Organ Transplantation / Q000009:adverse effects*; D036801:Parturition; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D061685:Time-to-Pregnancy; D066027:Transplant Recipients; D016896:Treatment Outcome
D007166:Immunosuppressive Agents