Background:Pregnancy after heart transplantation (HT) is a concern for many female recipients. The International Society for Heart and Lung Transplantation has guidelines regarding reproductive health, but limited data exist regarding providers’ attitudes and practices surrounding pregnancy post-HT.Methods:We conducted an independent, confidential, voluntary, web-based survey sent electronically to 1643 United States heart transplant providers between June and August 2019.Results:There were 122 responses, the majority from cardiologists (n=85, 70%) and nurse or transplant coordinators (n=22, 18%). Thirty-one percent (n=37) of respondents indicated that pregnancy should be avoided in all HT recipients, and only 43% (n=52) reported that their center had a formal policy regarding pregnancy following HT. The most commonly reported contraindications included nonadherence (n=109, 89%), reduced left ventricular ejection fraction (n=104, 85%), coronary allograft vasculopathy (n=86, 70%), prior rejection (n=76, 62%), presence of donor-specific antibodies (n=69, 57%), and prior peripartum cardiomyopathy pretransplant (n=57, 47%). Respondent sex, specialty, transplant volume, or prior experience with pregnancy after HT were not associated with recommendations to avoid posttransplant pregnancy.Conclusions:Transplant providers’ attitudes regarding posttransplant pregnancy vary widely. Despite International Society for Heart and Lung Transplantation guidelines, a significant proportion indicates that pregnancy is contraindicated in all recipients and the majority of programs have no center-specific policy to manage such pregnancies. While the low response rate limits the generalizability of the findings, they do suggest that education on the feasibility of pregnancy post-HT is indicated as many recipients are of, or survive to, childbearing age.

中文翻译：

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心脏移植后怀孕周围的练习方式。

背景：心脏移植术（HT）后的怀孕是许多女性接受者关注的问题。国际心脏和肺移植学会制定了有关生殖健康的准则，但关于提供者围绕HT后怀孕的态度和做法的数据很少。在2019年6月至2019年8月之间向州的心脏移植提供者进行了调查。结果：有122份回复，大多数来自心脏病专家（n = 85，70％）和护士或移植协调员（n = 22，18％）。31％（n = 37）的受访者表示应在所有HT接受者中避免怀孕，只有43％（n = 52）的受访者表示他们的中心对HT之后的怀孕有正式政策。最常见的禁忌症包括不依从（n = 109，89％），左心室射血分数降低（n = 104，85％），同种异体冠状动脉血管病变（n = 86，70％），先前排斥反应（n = 76，62） ％），存在供体特异性抗体（n = 69，57％）和先前的围产期心肌病移植前（n = 57，47％）。被调查者的性别，专长，移植量或HT后的怀孕经历与避免移植后妊娠的建议无关。结论：移植提供者对移植后妊娠的态度差异很大。尽管有国际心脏和肺移植协会的指导方针，但仍有很大一部分表明所有接受者均禁止妊娠，而且大多数计划都没有针对此类妊娠的中心特定政策。