Pregnancy After Liver Transplantation: Risks and Outcomes.

Area of Science:

• Hepatology
• Transplant Surgery
• Obstetrics and Gynecology

Background:

• Liver transplantation outcomes have improved, leading to increased post-transplant pregnancies.
• Managing pregnancy in liver transplant recipients requires specialized care due to potential complications.

Purpose of the Study:

• To evaluate pregnancy outcomes in women who have undergone liver transplantation.
• To identify maternal and fetal complications associated with post-liver transplant pregnancies.

Main Methods:

• Retrospective review of clinical data from liver transplant recipients between 2007 and 2016.
• Analysis of indications for transplantation, recipient age, time to conception, pregnancy complications, delivery type, neonatal health, and immunosuppressive therapy.

Main Results:

• Out of 1890 liver transplant recipients, 185 women were of childbearing age, with 18 (9.7%) experiencing 26 pregnancies.
• The mean age at transplantation was 25.3 ± 5.2 years, with conception occurring a mean of 32.7 ± 15.3 months post-transplant.
• Seventeen pregnancies (65.4%) resulted in live births; 6 (23%) had no maternal or fetal complications. Pregnancy-induced hypertension was the most common maternal complication (16.6%).

Conclusions:

• Pregnancies in liver transplant recipients remain higher risk than in the general population.
• Comprehensive discussion of fertility and pre-transplant counseling are essential.
• Close follow-up by a multidisciplinary team is recommended for pregnant liver transplant recipients.