Outcomes and management strategies of pregnancies after heart and lung transplantation across Europe
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Literature on pregnancy after heart and/or lung transplantation (HTx, LTx, HLTx) remains sparse. This study assessed short- and long-term outcomes of pregnancies post-thoracic organ transplantation across Europe and analyzed center management of these patients. Methods European centers provided retrospective data on post-HTx/LTx pregnancies and center strategies for handling transplant recipients with a pregnancy wish. Descriptive statistics and linear regression analysis were used. Results Forty-two females had 50 pregnancies across 12 European centers. Pregnancy induced hypertension occurred in 50% (HTx), 28% (LTx) and 20% (HLTx) and preeclampsia in 19%, 16% and 20%, respectively. Preterm birth (<37 weeks) occurred in 23% (HTx) and 68% (LTx) and birth weight <2500 grams in 8% and 58%, respectively. Live birth rate was 98%. In multivariable analysis, a trend for higher birth weight with higher pre-pregnancy eGFR was observed (B 13.3, 95% CI -1.7-28.4, p=0.08). Graft function remained stable in most patients during and after pregnancy. During follow-up (mean 15 years, range 5-31 post-transplantation), 6/40 mothers (15%) died (1 HTx, 2 LTx, 3 HLTx), with their children aged 0-11 years. No specific physical health problems were mentioned in 29/30 children (age 0-22 years). Physician opinions towards pregnancy differed from reluctant (31%) to positive (69%), with numerous management variations. Conclusions We show reassuring pregnancy outcomes for post-HTx, LTx and HLTx patients in an exclusive European cohort, despite high pregnancy complication rates. Graft function and overall maternal survival appear unaffected. We highlight differences in pregnancy management between centers and suggest development of a uniform approach.
Source: JHLT Open
Authors: Jildau R. Meinderts, Linda W. van Laake, Dieuwertje Ruigrok, Olivier Manintveld, Jérôme Le Pavec, Michael Perch, Jens Gottlieb, Adelheid Görler, Robin Vos, Jesper M. Magnusson, Claire Merveilleux du Vignaux, Aniko Bohács, Balazs Sax, Tanel Laisaar, Vincent Bunel, Margriet E. Gosselink, Merel E. Hellemons, Kevin Damman, Jelmer R. Prins, A. Titia Lely, Erik A.M. Verschuuren, Margriet F.C. de Jong
Institutions: University Medical Center Groningen, University of Groningen, Utrecht University, University Medical Center Utrecht, Erasmus MC, Erasmus MC Hart en Vaat Instituut, Erasmus MC Transplant Institute, Hôpital Marie Lannelongue, University of Copenhagen, Rigshospitalet, Medizinische Hochschule Hannover, German Center for Lung Research, Universitair Ziekenhuis Leuven, KU Leuven, University of Gothenburg, Hospices Civils de Lyon, Hôpital Louis Pradel, Semmelweis University, Tartu University Hospital, Assistance Publique – Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,500
OpenAlex ID: W7118243262