Successful Outcome After a Technically Challenging Liver Transplant During Pregnancy

• DOI: 10.1016/j.transproceed.2007.02.090
• Publication Date: 2007-06-18T03:32:29Z
• Authors: Z. Jankovic; D. Stamenkovic; B. Duncan; R. Prasad; M. Davies
• Keywords: Adult; Liver Cirrhosis, Biliary; Infant, Newborn; Liver Transplantation; 3. Good health; Pregnancy Complications; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Pregnancy; Humans; Female

Little is known about the implications of liver transplantation (OLT) during pregnancy. We report the case of a 26-year-old woman with cryptogenic familial biliary cirrhosis that decompensated rapidly. OLT was performed using the donor iliac vein for a retrogastric portal vein conduit to the superior mesenteric vein and the donor iliac artery for an infrarenal aortic conduit. During the latter anastomosis, a viable fetus was noticed. Both donor and recipient were cytomegalovirus positive. Postoperative ultrasound revealed a 13.5-week-old viable fetus. The patient received tacrolimus, azathioprine, and prednisolone. The pregnancy progressed normally with the vaginal delivery of a healthy male infant after 36 weeks gestation. Nineteen months later, both the mother and child were well. This case demonstrated that even technically difficult OLT during pregnancy can have a successful outcome, raising the question of whether transplant patients of childbearing age should be routinely tested for pregnancy.