MEDtube Science 2017 - Pregnancy In Liver Recipients – Management And Outcome. Review

Possession of the offspring and experiencing maternity is desired by many women, including solid-organ transplant recipients. The number of women post liver transplantation (LT) in reproductive age in the USA is approximately 14 000 and raises up to 500 more new cases each year. Moreover, 1/3 of LTs is performed in women of reproductive age. It is necessary to emphasize that pregnancy after LT is a high risk pregnancy, yet it does not increase the risk of graft rejection. In 2017 the first case of woman giving birth to a healthy child after ABO-incompatible LT was described. A period of 1-2 years between LT and conception is considered safe. Complications of pregnancy such as increased risk of hypertension, preeclampsia or gestational diabetes are more frequent among liver recipients than in general population. Increased risk of low birth weight, preterm birth and graft rejection were reported if the conceiving took place within the first year after transplantation. Choosing the right lifestyle, contraceptives and preventing drug interactions are pivotal tasks for the gynaecologist at the time. Management of patients wishing to become pregnant after LT should be based on the lowest effective dose of immunosuppressant. Calcineurin inhibitors and glucocorticosteroids are currently recommended in this group of patients.