Pregnancy after liver transplantation. How safe? A retrospective case-series study in a large tertiary hospital

To study pregnancies achieved after liver transplantation in terms of obstetric complications, maternal, neonatal outcomes and post-pregnancy allograft function.

A retrospective study of prospectively collected data was conducted, enrolling women with a history of liver transplantation performed in the Transplantation Unit of our hospital that delivered in our department. Obstetric characteristics and antenatal complications were reviewed. Apgar score, admission to Neonatal Intensive Care Unit (NICU) and need for emergency intubation were analyzed. Outcomes of regular follow-up concerning all complications of allograft function observed after pregnancy were also studied.

There were five cases of allograft recipients delivering their pregnancies during the study period. Mean maternal age was 32.2 ± 5 years. Interval from transplantation to delivery ranged from 40 to 219 months. Mean gestational week at delivery was 34.4 ± 2.5 weeks. Antenatal complications observed were pre-eclampsia (3 of 5 cases) and vaginal bleeding (1 of 5 cases). All preterm neonates were admitted to NICU, but no emergency intubation was demanded. One patient died a month after delivery, while three others were complicated by implant dysfunction up to 5 years after the delivery.

Pregnancy in a liver transplant recipient is associated with complications for mother and infant.