Pregnancy following liver transplantation:
The first report of successful pregnancy after liver transplantation was published in 1978.
Pregnancy after liver transplantation is often successful, but it must be regarded as a high risk, possibly associated with hypertension, preeclampsia, intrauterine growth retardation, and prematurity.
It is best delayed until 1 to 2 years after grafting.
Pregnancy planned at least 2 years after liver transplantation with stable allograft function can have excellent maternal and neonatal outcome.
In most female recipients studied, pregnancy does not appear to cause excessive or irreversible problems in graft function if the function of transplanted organ is stable prior to pregnancy, including twins if the woman has stable hepatic function before pregnancy.
In female recipients in contrast to the general population, a high incidence of low birth-weight and prematurity has been a consistent outcome.
Immunosuppressive agents may cause hypertension, preeclampsia and renal dysfunctionp in these recipients.
Immunosuppression during pregnancy is not teratogenic and does not lead to congenital anomalies.
Nearly 70% of pregnancies after systemic administration of tacrolimus resulted in a favourable outcome without any significant effect on intrauterine growth.
Also, it was found that tacrolimus may decrease the incidence of onset of hypertension and toxemia of pregnancy.
Thus, during pregnancy, the female recipient may continue the immunosuppressive regimen to stabilize the transplanted liver function but prevent the effect on the intrauterine growth.
To the present, 37 cases of pregnancies after liver transplantation have been reported worldwide.
In conclusion:
Under careful monitoring a childbearing age woman with stable and adequate liver function may have a successful pregnancy and a delivery after liver transplantation.
.
The first report of successful pregnancy after liver transplantation was published in 1978.
Pregnancy after liver transplantation is often successful, but it must be regarded as a high risk, possibly associated with hypertension, preeclampsia, intrauterine growth retardation, and prematurity.
It is best delayed until 1 to 2 years after grafting.
Pregnancy planned at least 2 years after liver transplantation with stable allograft function can have excellent maternal and neonatal outcome.
In most female recipients studied, pregnancy does not appear to cause excessive or irreversible problems in graft function if the function of transplanted organ is stable prior to pregnancy, including twins if the woman has stable hepatic function before pregnancy.
In female recipients in contrast to the general population, a high incidence of low birth-weight and prematurity has been a consistent outcome.
Immunosuppressive agents may cause hypertension, preeclampsia and renal dysfunctionp in these recipients.
Immunosuppression during pregnancy is not teratogenic and does not lead to congenital anomalies.
Nearly 70% of pregnancies after systemic administration of tacrolimus resulted in a favourable outcome without any significant effect on intrauterine growth.
Also, it was found that tacrolimus may decrease the incidence of onset of hypertension and toxemia of pregnancy.
Thus, during pregnancy, the female recipient may continue the immunosuppressive regimen to stabilize the transplanted liver function but prevent the effect on the intrauterine growth.
To the present, 37 cases of pregnancies after liver transplantation have been reported worldwide.
In conclusion:
Under careful monitoring a childbearing age woman with stable and adequate liver function may have a successful pregnancy and a delivery after liver transplantation.
.
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