The Nobel Laureate Joseph Murray provided the first report of pregnancy in a transplant recipient (1). Since that time, over 16,000 pregnancies have been documented in the world literature (2). Many more pregnancies have clearly occurred, now that pregnancy after transplantation is commonplace and is rarely reported. The data about pregnancy in transplant recipients come from case reports and registry reports, but these sources underrepresent the population of transplant recipients who have become pregnant (2).
This review relies on data from registry reports in the United States, the United Kingdom, and Europe, but we caution that the derivation of guidelines from these reports must be considered in light of their relatively small numbers. Furthermore, it is important to realize that registry reports are generally based on voluntary patient reporting and that they do not reflect data from prospective or retrospective reviews of hospital records or laboratory testing. Many investigators suggest that large well-designed prospective analyses are needed to address many of the questions regarding the risks of pregnancy after transplantation for both mother and child.
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