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Related Experiment Videos

Pregnancy after liver transplantation

Y Baruch1, Z Weiner, R Enat

  • 1Department of Medicine B, Rambam Medical Center, Haifa, Israel.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|June 1, 1993
PubMed
Summary

Successful pregnancies after liver transplantation are possible with careful monitoring. These cases highlight positive outcomes for women with end-stage liver disease on immunosuppressive therapy, including cyclosporin A.

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Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Obstetrics & Gynecology

Background:

  • Liver transplantation is a life-saving procedure for end-stage liver disease (ESLD).
  • Pregnancy following liver transplantation presents unique challenges for both mother and fetus.
  • Immunosuppressive therapy is crucial for graft survival but can impact reproductive health.

Observation:

  • Two women with ESLD who underwent liver transplantation became pregnant.
  • Both patients were managed on triple immunosuppressive therapy, including prednisone, azathioprine, and low-dose cyclosporin A.
  • Continuous monitoring included pulsed Doppler waveform measurements to assess fetal well-being and maternal health.

Findings:

  • The first patient, with Wilson's disease, delivered a healthy female infant at 38 weeks' gestation.

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  • The second patient, with HBV-related postnecrotic cirrhosis, delivered a healthy male infant at 35 weeks' gestation, despite early pregnancy and noted episodes of elevated liver enzymes and osteoporosis.
  • Both pregnancies resulted in healthy neonates, supporting the safety of current immunosuppressive regimens.

    • Implications:

    • These cases contribute to the growing evidence supporting successful pregnancies post-liver transplant.
    • Cyclosporin A-based immunosuppression appears compatible with achieving healthy pregnancy outcomes in liver transplant recipients.
    • Careful multidisciplinary monitoring is essential for managing pregnancies in this high-risk population.