A survey of solid organ transplant recipient attitudes and concerns regarding contraception and pregnancy

Author:

McIntosh Tristan1,Puerzer Payton2,Li Miah T.3,Malat Gregory4,Sammons Chelsea4,Norris Maxwell4,Fallah Tara4,Trofe‐Clark Jennifer456,DuBois James M.1,Iltis Ana7,Mohan Sumit3ORCID,Sawinski Deirdre8ORCID

Affiliation:

1. Bioethics Research Center Department of Medicine Washington University School of Medicine St. Louis Missouri USA

2. School of Arts and Sciences University of Pennsylvania Philadelphia Pennsylvania USA

3. Department of Medicine Division of Nephrology Columbia University Vagelos College of Physicians and Surgeons NY New York USA

4. Department of Pharmacy Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA

5. Renal, Electrolyte, and Hypertension Division Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA

6. Department of Surgery Division of Transplantation Perelman School of Medicine University of Pennsylvania Pennsylvania USA

7. Center for Bioethics Health and Society Wake Forest University Winston‐Salem North Carolina USA

8. Weill Cornell Medical College Department of Medicine, Division of Nephrology and Transplantation New York New York USA

Abstract

AbstractIntroductionMany women who are solid organ transplant (SOT) recipients wish to have children after transplantation. Contraception is an important component of post‐transplant planning and care, given the increased risk associated with post‐transplant pregnancies. We sought to understand patient attitudes and concerns about post‐transplant contraception and pregnancy.MethodsFollowing a comprehensive literature review, our team developed a survey that was administered to female SOT recipients of childbearing age. We used descriptive and inferential statistics to characterize participant viewsResultsA total of 243 transplant recipients completed the survey (80.7% response rate). The mean age of respondents was 37.5 years (±8.1 years), 66.7% were kidney recipients, and 40.7% were within the first year after transplant. The most common concerns among respondents included fetal and maternal health complications. Participants generally did not agree that transplant recipients should be advised to avoid pregnancy. There was strong support for shared decision‐making about pregnancy after transplantationConclusionUnderstanding patient perspectives can help transplant providers make better care recommendations and support patient autonomy in reproductive decisions post‐transplant. Given that there are some differences in views by transplant type, individualized conversations between patients and providers are needed.

Publisher

Wiley

Subject

Transplantation

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