Discussions about reproductive and sexual health should be included in transition education for the transplant recipient based on the youth’s age, developmental level, and risks. Pediatric transplant providers may feel uncomfortable approaching sexual health due to a limited knowledge base and the sensitivity of the topic, but they can provide general information about reproductive healthcare from the transplant perspective. In-depth discussions should be responsibility of team members who are experts in this content, have a trusting relationship with teens, and who are comfortable in discussing these issues and answering the AYA’s questions with sensitivity and in confidence. The AYA should be referred to Adolescent Medicine within the pediatric center or to a local gynecology provider to complete an adolescent history and examination. The “5 P” assessment may be completed by the pediatric team to understand the youth’s general perspective of sexual health and to engage them in discussion. These five questions address partners, practices, history of STI, presentation of STI, and prevention of pregnancy.
Helpful links on sexual health assessment:
- Taking a Client-Centered Sexual History
- The Five “P”s
- Explore the 5Ps method for taking a sexual history
References:
Ardura MI, et al.. Promoting safe sexual practices and sexual health maintenance in pediatric and young adult solid organ transplant recipients. Pediatr Transplant. 2021 Feb;25(1):e13949. doi: 10.1111/petr.13949. Epub 2021 Jan 25. PMID: 33491268.
Coscia LA et al. Pregnancy after transplant in the older adolescent: Anticipatory guidance for the pediatric provider. Pediatr Transplant. 2024 Jun;28(4):e14752. doi: 10.1111/petr.14752. PMID: 38682682.
Yo JH, Fields N, Li W, et al. Adverse Pregnancy Outcomes in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024;7(8):e2430913. doi:10.1001/jamanetworkopen.2024.30913
Katz-Greenberg G, et al. American Society of Transplantation Women’s Health Community of Practice Reproductive Health, Contraception and Pregnancy after Transplantation and Living Donation Controversies Conference Participants. Pregnancy After Solid Organ Transplantation: Review of the Evidence and Recommendations. Transplantation. 2025 Sep 1;109(9):1483-1494. doi: 10.1097/TP.0000000000005341. Epub 2025 Mar 13. PMID: 40838865; PMCID: PMC12354071.
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