Counselling, Research Gaps, and Ethical Considerations Surrounding Pregnancy in Solid Organ Transplant Recipients

被引:4
作者
Sawinski, Deirdre [1 ]
Ralston, Steven J. [2 ]
Coscia, Lisa [3 ]
Klein, Christina L. [4 ]
Wang, Eileen Y. [5 ]
Porret, Paige [6 ]
O'Neill, Kathleen [5 ]
Iltis, Ana S. [7 ]
机构
[1] Weill Cornell Med Coll, Nephrol & Transplantat, New York, NY 10021 USA
[2] Penn Hosp, Dept Obstet & Gynecol, Philadelphia, PA 19107 USA
[3] Gift Life Inst, Transplant Pregnancy Registry TPR Int, Philadelphia, PA USA
[4] Piedmont Atlanta Hosp, Piedmont Transplant Inst, Dept Transplantat, Atlanta, GA USA
[5] Univ Penn, Dept Obstet & Gynecol, Perelman Sch Med, Philadelphia, PA 19104 USA
[6] Univ Alabama Birmingham, Dept Surg, Birmingham, AL USA
[7] Wake Forest Univ, Ctr Bioeth Hlth & Soc, Winston Salem, NC 27101 USA
关键词
Ethics; Heart transplantation; Kidney transplantation; Liver transplantation; Lung transplantation; Pregnancy; SHARED DECISION-MAKING; CHRONIC KIDNEY-DISEASE; OUTCOMES; PERSPECTIVES; WOMEN;
D O I
10.1007/s11673-022-10219-2
中图分类号
B82 [伦理学(道德学)];
学科分类号
摘要
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.
引用
收藏
页码:89 / 99
页数:11
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