Since cardiac transplants first entered the scene in the 1980s and with improved immunosuppression regimens, more women are having pregnancies in the setting of previous cardiac transplants. However, they remain far fewer than renal or liver transplants and most sites have less experience across the globe. There remains only one case series published in Australia in Queensland in recent years.
Here we present a 30 yo G1P0 who at present time is 20/40, and received an orthotopic heart transplant in 2014 following a Fontan's for complex congenital heart disease at the age of 18. She lives in remote Northern Territories and her care is being shared across 3 states, a remote GP clinic and 5 hospitals.
Her past medical history in brief includes Right isomerism with dextrocardia and Atrioventricular defect, and abdominal malrotation & asplenia as related to heterotaxy. She required a Fontan's which was complicated by a DVT and cirrhosis. She had a successful transplant in 2014, complicated by proximal LAD stenosis, of up to 20% on angiogram in 2025. Her last TTE reports an LVEF of 55% with moderate mitral regurgitation. In 2017 she developed post transplant lymphoproliferative disease which is now in remission after receiving R CHOP.
She lives in NT, will move to TAS for greater family support and care is shared with tertiary centres in Melbourne. Planning is ongoing for delivery.
Risks are similar to that of other solid organ transplants including HTN, PET, infection, FGR and pre term labour.