Background: The use of tacrolimus (FK506, PROGRAF) in pregnant lung transplant recipients has been very rarely reported.
Case: A 32-year-old woman, gravida 1, para 0, had previously undergone a unilateral lung transplant secondary to pulmonary fibrosis. Four years later she spontaneously conceived. During pregnancy, she was maintained on an immunosuppressive regimen of tacrolimus and prednisone. Bi-weekly pulmonary function testing remained unchanged until 34 weeks' gestation. At that time, labor was induced due to concern for allograft rejection. A healthy, 2,208-g, female infant was born via an uncomplicated vaginal delivery. Postpartum transbronchial biopsy showed minimal acute cellular rejection.
Conclusion: Lung transplant recipients may achieve successful pregnancy outcomes with the use of tacrolimus.