Pregnancy after Liver Transplantation
Journal Title: Current Trends in Gastroenterology and Hepatology - Year 2018, Vol 1, Issue 1
Abstract
In 1978, Walcott and coworkers documented the first pregnancy in a liver transplant recipient [1]. The recipient’s immunosuppressive regimen included prednisone and azathioprine. Her pregnancy was uncomplicated, and she delivered a healthy male, weighing 2400 g, at term. Since Walcott’s report, there have been hundreds of pregnancies reported worldwide in liver transplant recipients. Whether the transplant could take in an adverse effect of the pregnancy or whether the pregnancy could potentiate liver transplant it is not settled [2]. Liver Transplant and Timing of Pregnancy Go to a) Women should wait at least 1 year after receiving a solidorgan transplant before attempting to get significant, and then should do so but when earned by the transplant team and obstetrician, with close monitoring [3]. b) The best contraceptive method, at least early after liver transplantation, is a barrier method. Later, when the patient is stabilized, hormonal methods may be considered. Sterilization is an option for patients who have completed their family [4]. c) Liver transplant recipients considering pregnancy should have preconception counseling with a maternal–fetal medicine specialist and their transplant physician. There are no specific guidelines for liver transplant recipients to decide whether an allograft is functioning sufficiently well for pregnancy as there is for kidney transplant recipients. Nevertheless, a general assessment of graft function and the status of comorbidities, such as high blood pressure, should be done before conception. The preconceptional visit also provides an opportunity to look back with the patient outcomes of pregnancies with liver transplants, potential effects of immunosuppressive agents on the pregnancy and fetus, and the plan of management for the gestation. Pregnancy outcome after liver transplantation Despite advances in immunosuppressive therapy, pregnancies in liver transplant recipients are still more risky than in the general population for both the mother and the fetus. Pregnancies in liver transplant recipients should be followed up more cautiously by a multidisciplinary team because [5,6]: a) Overall, 78% of pregnancies were successful. b) Many recipients of solid-organ transplants, including liver transplants, develop high blood pressure and renal dysfunction. It is easily grounded in the obstetrical literature that these conditions are independently linked with adverse pregnancy events. The most common obstetric complications were high blood pressure (28%), preeclampsia (12%), and reversible liver dysfunction (27%) [7].
Authors and Affiliations
Mohamed Nabih EL Gharib
Keywords
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- EP ID EP567430
- DOI 10.32474/CTGH.2018.01.000101
- Views 63
- Downloads 0
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