Springer Nature is making Coronavirus research free. View research | View latest news | Sign up for updates

Outcome of pregnancy after organ transplantation: a retrospective survey in Italy

  • 14 Accesses

  • 4 Citations


The number of women who decide to have a child after organ transplantation has increased. We determined the outcomes of 67 pregnancies of women who had undergone kidney, liver or heart transplantation. All recipients had been maintained on immunosuppressive therapy before and during pregnancy. Pregnancy complications at term were observed in 17 out of 67 women (25%), hypertension being the most frequent complication (16.17%). Two transplant rejections were reported. Sixty-eight infants were delivered (including one pair of twins); five women had two pregnancies at term. Twenty-eight miscarriages (29.2%) were recorded. Of these 68 babies (including the pair of twins), 40 (58.8%) were born at term and 28 (41.2%) before term. The babies were followed-up for 2 months to 13 years. According to our previous experience, our study shows that patients who have undergone organ transplantation can give birth to healthy infants as long as they are monitored accurately during pregnancy.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2


  1. 1.

    Bailey LL. Organ transplantation: a paradigm of medical progress. Hastings Cent Rep 1990; 20:24.

  2. 2.

    Radomski JS, Ahlswede BA, Jarrell BE, et al. Outcomes of 500 pregnancies in 335 female kidney, liver, and heart transplant recipients. Transplant Proc 1995; 27:1089.

  3. 3.

    Kirk E. Paul Organ transplantation and pregnancy. A case report and review. Am J Obstet Gynecol 1991; 164:1629.

  4. 4.

    Mecacci F, La Torre P, Parretti E, et al. Trapianto renale e gravidanza. Nostra esperienza su un caso. Minerva Ginecol 1998; 50:481.

  5. 5.

    Davison JM. Dialysis, transplantation and pregnancy. Am J Kidney Dis 1991; 27:127.

  6. 6.

    Albengres E, Le Louet H, Tillement JP. Immunosuppressive drugs and pregnancy: experimental and clinical data. Transplant Proc 1997; 29:2461.

  7. 7.

    Ritschel WA. In: Kuemmerle HP, Brendel K (eds). Clinical pharmacology in pregnancy. Thieme-Stratton, New York 1984; p 59.

  8. 8.

    Pisky L, Di George AM. Cleft palate in mouse: a teratogenic index of glucocorticoid potency. Science 1965; 147:402.

  9. 9.

    Chabria S. Aicardi’s syndrome: are corticosteroids teratogenic? Arch Neurol 1981; 38:70.

  10. 10.

    Saarikowski S, Seppala M. Immunosuppression during pregnancy: transmission of azathioprine and its metabolites from the mother to the fetus. Am J Obstet Gynecol 1973; 115:1100.

  11. 11.

    Armenti VT, Ahlswede KM, Ahlswede BA, Jarrell BE, Moritz MJ, Burke JF. National Transplantation Pregnancy Registry: outcomes of 154 pregnancies in cyclosporine-treated female kidney transplant recipient. Transplantation 1994; 57:502.

  12. 12.

    Bermas BL, Hill J.A. Effect of immunosuppressive drugs during pregnancy. Arthritis Rheum 1995; 38:1722.

  13. 13.

    Classen JB, Sevach EM. Evidence that cyclosporine treatment during pregnancy predispose offspring to develop antibodies. Transplantation 1991; 51:1052.

  14. 14.

    Rose ML, Dominguez M, Leaver N, Lachno R, Yacoub MH. Analysis of T cell subpopulation and cyclosporine levels in the blood of two neonates born to immunosuppressed heart–lung recipients. Transplantation 1989; 48:223.

  15. 15.

    Yoshimura N, Oka T, Fujiwara Y, Yasumura T, Honjo H. A case report of pregnancy in renal transplant recipient treated with FK506 (tacrolimus). Transplantation 1996; 61:1552.

  16. 16.

    Nomoto S, Fujiwara H, Ban T, Ohara K. Cardiotoxicity of long-term intravenous administration of FK506 in rabbits: dose relationship and recovery after discontinuance. Transplant Proc 1994; 26:855.

  17. 17.

    Vyas S, Kumar A, Piecuch S, et al. Outcome of twin pregnancy in a renal transplant recipient treated with tacrolimus. Transplantation 1999; 67:490.

  18. 18.

    Sakaguchi S, Sakaguchi N. Thymus and autoimmunity: transplantation of the thymus from cyclosporine A-treated mice causes organ-specific autoimmune disease in athymic nude mice. J Exp Med 1988; 167:1479.

  19. 19.

    Sakaguchi S, Sakaguchi N. Organ-specific autoimmune disease induced in mice by elimination of T cell subsets: neonatal administration of cyclosporine A causes autoimmune disease. J Immunol 1989; 142:471.

  20. 20.

    Takahashi N, Nishida H, Hoshi J. Severe B cell depletion in newborns from renal transplant mothers taking immunosuppressive agents. Transplantation 1994; 57:1617.

  21. 21.

    Stratta P, Giacchino F, Canadese C, Segoloni G, Massobrio M. La gravidanza in donne con trapianto renale. In: Capetta P, Bertulessi C, Moro G (eds). Gestosi 1993. CIC edizioni internazionali, Rome, 1993; p 125.

  22. 22.

    Davison J, Baylis C. Renal disease. In: De Swiet M (ed). Medical disorders in obstetric practice. Blackwell Science, Berlin 1995; p 261.

  23. 23.

    Armenti VT, Ahlswede KM, Carter JR, Moritz MJ, Burke JF. National Transplantation Pregnancy Registry: analysis of outcome/risk of 394 pregnancies in kidney transplant recipients. Transplant Proc 1994; 26:2535.

  24. 24.

    Armenti VT, Ahlswede KM, Ahlswede BA, et al. Variables affecting birthweight and graft survival in 197 pregnancies in cyclosporine-treated female kidney transplant recipients. Transplantation 1995; 59:476.

  25. 25.

    Armenti VT, Jarrell BE, Radomski JS, McGrory CH, Gaughan WJ, Moritz MJ. National Transplantation Pregnancy Registry (NTPR): Cyclosporine dosing and pregnancy outcome in female transplant recipients. Transplant Proc 1996; 28:2111.

  26. 26.

    Cararach V, Monleòn FJ. Pregnancy after renal transplantation: 25 years experience in Spain. Br J Obstet Gynecol 1993; 100:122.

  27. 27.

    Gaughan WJ, Moritz MJ, Radomski JS, Burke JF, Armenti VT. National Transplantation Pregnancy Registry: report on outcomes in cyclosporine-treated female kidney transplant recipients with an interval from transplant to pregnancy of greater than five years. Am J Kidney Dis 1996; 28:266.

  28. 28.

    Rieu P, Neyrat N, Hiesse C, Charpentier B. Thirty-three pregnancies in a population of 1725 renal transplant patients. Transplant Proc 1997; 29:2459.

  29. 29.

    Scantelbury V, Gordon R, Tsakis A, Starzl TE. Childbearing after liver transplantation. Transplantation 1990; 49:317.

  30. 30.

    Morini A, Spina V, Oleandri V, Cantonetti G, Lambiasi A, Papalia U. Pregnancy after heart transplant: update and case report. Hum Reprod 1998; 13:749.

  31. 31.

    Classen JB, Shevach EM. Cyclosporine induced autoimmunity in newborns prevented by early immunization. Autoimmunity 1998; 1:1.

  32. 32.

    Pilarsky L, Yacyshyn B, Lazarovits AI. Analysis of peripheral blood lymphocyte populations and immune function from children exposed to cyclosporine or azathioprine in utero. Transplantation 1994; 57:133.

  33. 33.

    Baarsma R, Kamps WA. Immunological responses in an infant after cyclosporine A exposure during pregnancy 1993; 152:476.

  34. 34.

    Dahlquist G, Frisk G, Ivarsson SA, Svanberg L, Forsgren M, Diderholm H. Indication that maternal coxsackie B virus infection during pregnancy is a risk factor for childhood-onset IDDM. Diabetologia 1995; 38:1371.

  35. 35.

    Cavazzutti GB. Caratteristiche e classificazione dei neonati. In: Cacciari E, Cao A, Cavazzutti GB, Guaraldi GP, Guglielmi M, Panizon F, Segni G, Zacchello F, Zanesco L. Principi e pratica di Pediatria. Monduzzi (ed) 1999; p 242.

  36. 36.

    Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human breast milk. Pediatrics 1989; 84:924.

  37. 37.

    Hunt SE. Pregnancy in heart transplant recipients: a good idea? J Heart Lung Transplant 1991; 10:499.

  38. 38.

    Kossoy LR, Herbert CM III, Wentz AC. Management of heart transplant patients: guidelines for obstetrician-gynecologist. Am J Obstet Gynecol 1988; 159:490.

  39. 39.

    Davison JM. Renal transplant and pregnancy. Am J Kidney Dis 1989; 9:374.

  40. 40.

    Branch KR, Wagoner LE, McGrory CH, et al. Risks of subsequent pregnancies on mother and newborn in female heart transplant recipients. J Heart Lung Transplant 1998; 17:698.

  41. 41.

    Radomsky JS, Moritz MJ, Jarrell BE, et al. Outcomes of multiple pregnancies in female liver transplant recipients. Hepatology 1995; 22:149A.

  42. 42.

    Ehrich JM, Lorait C, Davison JM, et al. Repeated successful pregnancies after kidney transplantation in 102 women (report by the EDTA Registry). Nephrol Dial Transplant 1996; 11:1314.

  43. 43.

    FG Cunningham, PC McDonald, NF Gant, et al. (eds). Hypertensive disorders in pregnancy. Williams Obstetrics, Appleton and Lange, Stamford, Conn 1997; p 693.

  44. 44.

    Lamarque V, Gelen MF, Monka C, Krupp P. Analysis of 629 pregnancy outcomes in transplant recipients treated with Sandimmun. Transplant Proc 1997; 29:2480.

  45. 45.

    Salmela KT, Kyllonen LEJ, Holmberg C, Riska CG. Impaired renal function after pregnancy in renal transplant recipient. Transplantation 1993; 56:1372.

  46. 46.

    Behrman RE, Kliefman RM, Arvin AM. Il neonato ad alto rischio. In: Nelson. Trattato di Pediatria. Minerva Med 1997; 447.

  47. 47.

    Pruvot FR, Declerck N, Valat-Rigot AS, et al. Pregnancy after liver transplantation: focusing on risks to the mother. Transplant Proc 1997; 29:2470.

  48. 48.

    Davison JM. Renal transplantation and pregnancy. Am J Kidney Dis 1989; 9:374.

  49. 49.

    Cattaruzza MS, Spinelli A. Spontaneous abortion in Italy: social differences and trends. E&P 2000; 24:166.

Download references

Author information

Correspondence to Roberto Miniero.

Additional information

This article was written on behalf of AIRT, NITp, Ocst, Italy

Dr. Curtoni has died since this article was completed

About this article

Cite this article

Miniero, R., Tardivo, I., Curtoni, E.S. et al. Outcome of pregnancy after organ transplantation: a retrospective survey in Italy. Transpl Int 17, 724–729 (2005).

Download citation


  • Transplant
  • Pregnancy
  • Newborn