Pregnancy after Transplant in the Older Adolescent: Anticipatory Guidance for the Pediatric Provider.

BackgroundHealthcare providers who care for adolescent and young adult transplant recipients should be aware of contraception counseling and potential for pregnancy in this at-risk cohort.MethodsThis paper will review contraceptive options in general for transplant recipients. There will also be a review of common immunosuppressive medications and their risk profile regarding pregnancy after transplantation. Data from the Transplant Pregnancy Registry International were analyzed looking at recipients conceiving under the age of 21 and were compared to overall pregnancy outcomes.ResultsOverall pregnancy outcomes in recipients under the age of 21 are like the adult cohort.ConclusionIt is imperative to provide contraception counseling to the adolescent and young adult and inform their caregiver that pregnancy can happen if the recipient is sexually active. Pregnant adolescent and young adult transplant recipients should be followed by a multidisciplinary team to assure a positive outcome for the recipient, transplant, and neonate. This manuscript will provide a brief review of current recommendations for contraception for adolescent and young adult solid organ transplant recipients, a short review of immunosuppression and pregnancy exposure, overview of outcomes in recipients who had a pregnancy before age 21 years, and pregnancy outcomes in the general transplant population.image