Pregnancy and Heart Transplantation. First Case in Mexico

The success of cardiac transplantation has included female recipients of childbearing age. Pregnancy is risky in these patients because of possibility of acute rejection and lost graft, birth defects of the product and complications related to pregnancy. Case report: 35 years old female at time heart transplant 26 months, before she present with pregnancy unscheduled. During the same we switched to azathioprine and eliminated mycophenolate mofetil; tacrolimus was continued as immunosuppressive therapy- She was monitored every 3 months with tacrolimus levels, echocardiography and last two months of pregnancy every 3 weeks, narrow prenatal control. Gestation had a normal evolution, no complications in heart graft, diseases related to pregnancy. Pregnancy finished by cesarean section and a male live product was obtained without congenital malformations. Control graft 3 months post cesarean with LVEF 60%. Conclusion: Pregnancy in recipients of heart transplant can be completed successfully, it is best to suggest prenatal care, and no pregnancy. If recipient want it has to be programmed and one year after cardiac transplantation without periods of severe rejection. Key words: Heart Transplant; Pregnancy; Acute Rejection; Immunosuppression