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Postpone pregnancy 1-2 years after a liver transplant. (Largest Single-Institution Series).
SAN FRANCISCO -- Liver transplant recipients who delay pregnancy for at least 1-2 years after transplantation until allograft function is more stable have a good chance of giving birth, Dr. Melissa C. Bush reported in a poster presentation at the annual meeting of the Society for Maternal-Fetal Medicine.
Of 38 pregnancies in 29 women who received liver transplants between 1992 and 2002, 20 women (69%) together had a total of 24 (63%) live births, said Dr. Bush of Mount Sinai School of Medicine, New York.
The retrospective analysis covered the largest series of pregnancies in liver transplant recipients reported from a single institution. Patients had undergone liver transplantation at Mount Sinai Medical Center, and all were taking tacrolimus or cyclosporin A, she said.
Among the Mount Sinai pregnancies, 14 ended in abortion--4 spontaneous and 10 performed electively because of worsening liver function in the first trimester. Pregnancies that ended in abortion occurred sooner after transplantation than pregnancies that resulted in live births. The interval between transplantation and conception was 24 months in the abortion group and 48 months in the live-birth group.
There were no intrauterine or neonatal deaths reported aside from the abortions; four minor congenital anomalies were found. All 5-minute Apgar scores were greater than 7. The mean gestational age at delivery was 36 weeks, and the mean birth weight was 2,762 g. Of the 24 live-born babies, 11 were delivered by C-section.
Four patients were treated during pregnancy for biopsy-proven graft rejection: one with mild rejection, two with moderate rejection, and ...
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