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Pregnancy outcomes in liver transplant recipients: A 15‐year single‐center experience
Author(s) -
Kanzaki Yu,
Kondoh Eiji,
Kawasaki Kaoru,
Mogami Haruta,
Chigusa Yoshitsugu,
Konishi Ikuo
Publication year - 2016
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13096
Subject(s) - medicine , pregnancy , liver transplantation , transplantation , tacrolimus , single center , obstetrics , retrospective cohort study , gestational age , biliary atresia , intrauterine growth restriction , pediatrics , surgery , gestation , genetics , biology
Aim There are an increasing number of reports of pregnancy following liver transplantation, but many questions remain regarding preconception counseling and management of the pregnancy. The aim of this study was to report pregnancy outcomes in women who had undergone liver transplants and to gain insight into these issues. Methods We conducted a retrospective review of liver transplant recipients who had received prenatal care at Kyoto University Hospital between January 2001 and December 2015. Results Twenty‐six consecutive pregnancies in 17 liver transplant recipients were identified during the period. The most common indication for liver transplantation was biliary atresia (65%). The median age at transplantation was 19 years (range, 2–38). The median age at conception was 28 years (range, 20–41) with a median time between transplantation and conception of 8 years (range, 0–22). A tacrolimus‐based immunosuppressive regimen ( n = 21, 81%) was the most common at the time of conception. There were 13 live births (50%), four spontaneous miscarriages (15%), and nine induced abortions (35%). Median gestational age at delivery was 38 weeks (range, 32–42), and the median birthweight was 2858 g (range, 1815–3864 g). Pregnancy and maternal complications included preterm deliveries (23%), intrauterine growth restriction (23%), pre‐eclampsia (8%), cesarean delivery (23%), bacterial infection (15%), and biopsy‐proven acute cellular rejection (15%). Two infants had congenital anomalies (tetralogy of Fallot and hydronephrosis). Conclusion Pregnancy after liver transplantation can achieve relatively favorable outcomes. Obstetricians should be involved in the contraceptive and fertility counseling of female transplant recipients to prevent unintended pregnancies.