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Childbearing after liver transplantation

Scantlebury, V and Gordon, R and Tzakis, A and Koneru, B and Bowman, J and Mazzaferro, V and Stevenson, WC and Todo, S and Iwatsuki, S and Starzl, TE (1990) Childbearing after liver transplantation. Transplantation, 49 (2). 317 - 321. ISSN 0041-1337

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Abstract

Seventeen female patients who underwent orthotopic liver transplantation between June 1973 and June 1987 became pregnant 5 months to 11 years after transplantation. Immunosuppression was maintained with combinations of prednisone, cyclosporine, and azathioprine prior to and during pregnancy. One patient discontinued immunosuppression after knowledge of pregnancy, taking only azathioprine sporadically. Mean age at time of delivery was 26 years. Twelve patients had no alteration in liver function studies; 7 patients demonstrated mild or moderate enzyme elevations prior to delivery, with one case of rejection confirmed by percutaneous liver biopsy. Major problems related to pregnancy were hypertension, anemia, and hyperbilirubinemia. Twenty live births occurred (2 patients had 2 separate pregnancies, one patient had a set of twins); 13 were by caesarian section, 7 by vaginal delivery. Eleven of the 13 caesarian births were premature by gestational age. All vaginal births were term. Toxemia of pregnancy and early rupture of membranes were the principal indications for caesarean section. There were no congenital abnormalities or birth defects and all the children are surviving well. Fifteen of 16 children older than one year all have normal physical and mental development, with one child manifesting immature speech development. Four children are under one year, all with normal milestones thus far. Sixteen of the 17 mothers are alive from 2—18 years after transplantation; the only death was from a lymphoma, almost 4 years after transplantation and 2½ years after delivery. This experience suggests that women undergoing liver transplantation can safely bear children despite an increased risk of premature caesarian births. The effect of chronic immunosuppression of female pediatric patients on their reproductive potential later in adulthood remains to be fully evaluated but the results so far are favorable. © 1990 by Williams & Wilkins.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Scantlebury, V
Gordon, R
Tzakis, A
Koneru, B
Bowman, J
Mazzaferro, V
Stevenson, WC
Todo, S
Iwatsuki, S
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1990
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 49
Number: 2
Page Range: 317 - 321
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062110907, Starzl CV No. 1048
Date Deposited: 08 Apr 2010 17:17
Last Modified: 30 Oct 2017 23:56
URI: http://d-scholarship.pitt.edu/id/eprint/4434

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