Counselling, Research Gaps, and Ethical Considerations Surrounding Pregnancy in Solid Organ Transplant Recipients.
Deirdre SawinskiSteven J RalstonLisa CosciaChristina L KleinEileen Y WangPaige PorretKathleen O'NeillAna S IltisPublished in: Journal of bioethical inquiry (2022)
Survival after solid-organ transplantation has improved significantly, and many contemporary transplant recipients are of childbearing potential. There are limited data to guide decision-making surrounding pregnancy after transplantation, variations in clinical practice, and significant knowledge gaps, all of which raise significant ethical issues. Post-transplant pregnancy is associated with an increased risk of maternal and fetal complications. Shared decision-making is a central aspect of patient counselling but is complicated by significant knowledge gaps. Stakeholder interests can be in conflict; exploring these tensions can help patients to evaluate their options and inform their deliberations. We argue that uniform, evidence-based recommendations for pregnancy after solid organ transplantation are needed. Conducting research, including patient-engaged studies, in this area should be priority for the transplant community.
Keyphrases
- pregnancy outcomes
- preterm birth
- decision making
- clinical practice
- healthcare
- case report
- end stage renal disease
- ejection fraction
- cell therapy
- pregnant women
- risk factors
- stem cells
- electronic health record
- smoking cessation
- prognostic factors
- hepatitis c virus
- gestational age
- birth weight
- weight gain
- case control
- artificial intelligence