Obstetric Anaesthesia Annual Scientific Meeting 2024

Anaesthetic, maternal and neonatal outcomes in cardiac transplant recipients

N Nadi, K Bhatia, A Zacharzewski

Department of Anaesthesia, Saint Mary’s Hospital, Manchester, UK

Introduction

•The population of female heart transplant recipients of reproductive age is on the rise due to advances observed in transplantation.

•Significant maternal morbidity and mortality has been reported in pregnant women with a cardiac transplant.

Methods

•We reviewed outcomes of five pregnancies in four cardiac transplant recipients managed by the multidisciplinary pregnancy heart team at our tertiary centre between 1st January 2015 – 31st December 2023.

•Characteristics of the women including their demographics, indications for cardiac transplant, mode of delivery, anaesthetic interventions and neonatal outcomes are described.

Results

•The median time from transplantation to delivery was 5.3 (IQR 4.3-8.2) years. There was no evidence of graft rejection or deterioration in cardiac function during all five pregnancies.

Conclusion

•Our small case series highlights that pregnancy outcomes in heart transplant recipients are favourable but are complicated by a high caesarean and preterm birth.

•Preconception counselling, titration of the immunosuppression and serial surveillance by the multidisciplinary cardio-obstetric team remain key aspects of care in pregnant women with a heart transplant.

References

1. Punnoose LR, Coscia LA, Armenti DP, Constantinescu S, Moritz MJ. Pregnancy outcomes in heart transplant recipients. J Heart Lung Transplant. 2020; 39:473-480.

2. Acuna S, Zaffar N, Dong S, Ross H, D'Souza R. Pregnancy outcomes in women with cardiothoracic transplants: A Systematic review and meta-analysis. J Heart Lung Transplant. 2020; 39: 93-102.

Obstetric Anaesthesia Annual Scientific Meeting 2024

Anaesthetic, maternal and neonatal outcomes in cardiac transplant recipients.

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