Planning a pregnancy after lung transplantation: Issues and considerations

Pregnancy after a lung transplant is relatively uncommon with a small number of cases in the literature. Here, a pre-pregnancy counselling appointment is described of a woman with a previous lung transplant due to cystic fibrosis planning pregnancy. The case highlights the clinical considerations before embarking on pregnancy. Pregnancy in a lung transplant recipient confers risk to the mother and fetus. It is critical to advise women on potential risks of pregnancy on lung transplant function, take the opportunity to undertake immunosuppressant tailoring (to avoid teratogenic complications) in conjunction with their specialist team with confirmation of stable allograft function before embarking on pregnancy. Risk stratification after careful consideration of the full history can help identify select individuals where pregnancy might be successful. Open discussion around the regular monitoring of lung function, screening for maternal-fetal complications and the risks are required.