Pregnancy after liver transplantation: a case series and review of the literature

Zullo, Fabrizio; Saccone, Gabriele; Donnarumma, L.; Marino, Ignazio R.; Guida, Maurizio; Berghella, Vincenzo

doi:10.1080/14767058.2019.1680632

Cited by 13 publications

(8 citation statements)

References 48 publications

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“…In contrast to the literature, no miscarriage was observed in our study, and the live birth rate was 100%; on the contrary, several reviews in the literature report a median miscarriage score of 12.9, and 2.3% of intrauterine fetal death, in contrast with our study [39] .…”

Section: Discussioncontrasting

confidence: 99%

Safe pregnancy after liver transplantation: Evidence from a multicenter Italian collaborative study

Sciarrone

Ferrarese

Bizzaro

et al. 2022

Digestive and Liver Disease

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Section: Discussioncontrasting

confidence: 99%

Safe pregnancy after liver transplantation: Evidence from a multicenter Italian collaborative study

Sciarrone

Ferrarese

Bizzaro

et al. 2022

Digestive and Liver Disease

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“…Many programs have also relied on their experience with pregnancy in other solid organ transplant recipients to inform their choice of regimen, as pregnancy in thousands of kidney and liver transplant recipients has provided the foundation of our knowledge of immunosuppression tolerability and safety in humans. [10][11][12][13][14] In summary, most transplant programs use induction therapy with ATG followed by maintenance therapy that is based on a calcineurin inhibitor such as tacrolimus. Almost all programs report using tripleagent maintenance immunosuppression; this regimen typically consists of a calcineurin inhibitor, an antimetabolite, and a steroid such as prednisone.…”

Section: Immunosuppression Regimensmentioning

confidence: 99%

“…Factors to consider in the choice of immunosuppression regimen include nephrotoxicity, safety profile in pregnancy, and the immunogenicity of the uterus graft. Many programs have also relied on their experience with pregnancy in other solid organ transplant recipients to inform their choice of regimen, as pregnancy in thousands of kidney and liver transplant recipients has provided the foundation of our knowledge of immunosuppression tolerability and safety in humans 10–14…”

Section: Introductionmentioning

confidence: 99%

Immunologic and Infectious Concerns in Uterus Transplantation

Porrett¹,

Nellore

2021

Clinical Obstetrics &Amp; Gynecology

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Pharmacologic immunosuppression is required for the success of uterus transplantation but can provoke several complications for the transplant recipient. In this review, we discuss the immunologic complications that can occur in the uterus transplant recipient. First, we provide the latest update on immunosuppression regimens used by programs throughout the world. Next, we discuss the prevalence, mechanisms, treatment, and outcome of rejection in uterus transplant recipients. Finally, we discuss infectious complications of varying severity alongside their treatment and impact.

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“…Liver transplantation is a treatment for acute or chronic diseases, which is an effective life-saving procedure [1,2,3] and is increasingly performed all over the world. The number of liver transplants is also increasing among women of childbearing (reproductive) age [3,4,5]. Consequently, there is an increasing number of reports of pregnancy following liver transplantation but doubts still exist regarding preconception counseling and the optimal method of managing pregnancy.…”

Section: Introductionmentioning

confidence: 99%

“…In the end stage of liver failure, women complain of irregular periods or their absence, very often they are infertile [3,7,8]. One of the effects of successful liver transplantation is the restoration of fertility and the ability to give birth to a healthy child in up to 97% of women [3,7,8].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy After Liver Transplant: Maternal and Perinatal Outcomes

Marzec

Słowakiewicz

Gozdowska

et al. 2020

Preprint

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Background: Liver transplantation is a life-saving and successful therapeutic procedure which is more and more frequent worldwide, also among women of reproductive age. Consequently, there is an increasing number of reports of pregnancy following liver transplantation, but doubts still exist regarding preconception counseling and the the optimal method of managing pregnancy. The aim of this study was to report and evaluate pregnancy outcomes in women who had undergone liver transplantation.Methods: We retrospectively analyzed female patients after orthotopic liver transplantation who reported pregnancy and were under medical care of a single transplant center.Results: We identified 14 pregnancies in 10 women who had undergone liver transplantation (12 childbirths, one induced abortion due to fetal death in the first trimester, one pregnancy is still ongoing). Causes of transplantation include congenital or acquired disorders and the most common indication was autoimmune hepatitis (50%). The mean age at the point of transplantation was 28.5 (range 21–36), mean maternal age at pregnancy was 32 (range 26-43), and transplant-to-pregnancy interval was 4.07 years (range 1,5–7). The mean gestational week was 36.67 (range 31–40). Immunosuppression was maintained with combinations of prednisone (n=11), tacrolimus (n=13), and azathioprine (n=8) prior to and during pregnancy. Two pregnancies were unintended, so women took mycophenolate mofetil in the first weeks of gestation. Another two women stopped taking azathioprine due to increasing anemia. Maternal complications included increase of aspartate transaminase and alanine transaminase (n=2), anemia (n=4) and hyperthyroidism (n=2). Among the 12 childbirths, five (41,67%) were preterm. Only five women entered labor spontaneously, while seven (58,33%) had cesarean delivery.Conclusions: Pregnancy after liver transplantation can achieve relatively favorable outcomes. It does not influence women’s fertility and, during pregnancy, we report low rates of minor graft complications. A multidisciplinary team should be involved in contraceptive, fertility and consequently pregnancy counseling of female transplant recipients.

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Pregnancy after liver transplantation: a case series and review of the literature

Cited by 13 publications

References 48 publications

Safe pregnancy after liver transplantation: Evidence from a multicenter Italian collaborative study

Safe pregnancy after liver transplantation: Evidence from a multicenter Italian collaborative study

Immunologic and Infectious Concerns in Uterus Transplantation

Pregnancy After Liver Transplant: Maternal and Perinatal Outcomes

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