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Pregnancy after liver transplantation.

UNLABELLED
Several reports on liver transplantation and pregnancy have been published recently. Uncertainty remains regarding appropriate management of these patients.


METHODS
The study included pregnant women of all ages with liver transplant referred to our center. A total of eight patients were identified and qualified for our study. The following variables were obtained: age, date of liver transplantation, date of conception, reasons for liver transplantation, type of immunosuppressive therapy, complications during pregnancy, gestational age at birth, birth weight, mode of delivery, the interval of time from liver transplantation to conception and co-morbidity.


RESULTS
The mean age of our population was 24 years. Four of the eight were nulliparous. The mean time interval from transplantation to pregnancy was eight years. The indication for liver transplantation in 75% of patients was autoimmune hepatitis. Two cases were associated with viral hepatitis. Combination therapy with more than one immunosuppressant was given to 75% of patients. The most prevalent complication was pyelonephritis in (38%), followed by gestational thrombocytopenia and preeclampsia. Most deliveries (75%) were vaginal and at term (88%). The median for gestational age was 39 weeks. The median birth weight was 2,898 grams.


CONCLUSIONS
This study proves that successful and uneventful pregnancies are likely in liver transplant patients under optimal obstetric management.