Pre-pregnancy treatment
| Delay conception minimum 1 year (preferably 2 years) after transplant |
| Good general health and stable graft function (organ-specific assessment) |
| No recent episodes of acute rejection or evidence of ongoing chronic rejection |
| No recent episodes of infection or evidence of ongoing chronic infection (HIV, hepatitis B virus, hepatitis C virus, cytomegalovirus, herpes simplex virus, human papillomavirus, syphilis, rubella, varicella or toxoplasmosis) |
| Vaccinations should be given if needed (rubella, tetanus, hepatitis B virus, influenza and pneumococcus) |
| Normal blood pressure or mild arterial hypertension with minimal antihypertensive regimen (preferably only 1 drug; no angiotensin-converting enzyme inhibitors) |
| Acceptable renal function (creatinine level <1.5 mg⋅dL−1) |
| Absent or minimal proteinuria (<0.5 g⋅day−1) |
| Absent or adequately controlled diabetes mellitus |
| Immunosuppressive regimen including prednisone (<15 mg⋅day−1), azathioprine (<2 mg⋅kg−1⋅day−1), cyclosporine or tacrolimus (low therapeutic levels); mycophenolate mofetil, sirolimus and everolimus are contraindicated (and should be stopped 6 weeks before conception) |
| Contraception is needed until planned pregnancy |
| Aetiology of original disease and relevant genetic issues discussed |
| Risks of intrauterine growth restriction, prematurity and low birth weight discussed. |
| Risks of maternal complications (hypertension, pre-eclampsia, diabetes, graft rejection and graft loss) discussed |
Reproduced and modified from [1] with permission from the publisher.