Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata, Okayama 700-8558, Japan.
Arch Gynecol Obstet. 2010 Mar;281(3):423-5. doi: 10.1007/s00404-009-1181-2. Epub 2009 Jul 18.
Pregnancies after orthotropic liver transplantation (OLT) have demonstrated favorable perinatal outcomes. However, obstetrical complications in OLT recipients are more common than those in a normal population. In countries where the number of cadaveric donors is limited, living-related liver transplantation (LRLT) is a valuable procedure, but few pregnancies after LRLT have been reported.
We present a case of a pregnant woman after LRLT who developed severe preeclampsia with fetal growth restriction (FGR), and a review of literature.
A 34-year-old nulliparous woman was referred to our hospital as a LRLT recipient. She was admitted to our hospital at 25 weeks' gestational age as she had developed severe preeclampsia, although her liver function was stable and there were no episodes for rejection or cholestasis. Emergency cesarean section was performed at 28 weeks' gestational age because of FGR and non-reassuring fetal status. Although there is no Medline available report in English of a successful pregnancy after LRLT, there are 11 cases of successful pregnancies after LRLT in the Japanese literature. These cases suggested that the incidences of preeclampsia, FGR, preterm delivery and cesarean delivery in pregnancies after LRLT are similar to those after OLT, but liver dysfunction and/or cholestasis in pregnancies after LRTL might be more common compared with those after OLT.
Careful observation is needed after LRLT and the potential for differences in risk with LRLT recipients in comparison to OLT recipients should be considered.
肝移植（OLT）后的妊娠已显示出良好的围产期结局。然而，OLT 受者的产科并发症比正常人群更为常见。在尸体供体数量有限的国家，活体相关肝移植（LRLT）是一种有价值的手术，但报告的 LRLT 后妊娠病例很少。
我们报告了 1 例 LRLT 后发生严重子痫前期伴胎儿生长受限（FGR）的孕妇，并对文献进行了回顾。
一名 34 岁的初产妇因 LRLT 患者被转诊至我院。她在 25 孕周时因严重子痫前期入院，尽管其肝功能稳定，且无排斥或胆汁淤积发作。由于 FGR 和胎儿状态不佳，在 28 孕周时行紧急剖宫产术。虽然没有 Medline 上有英语报道 LRLT 后成功妊娠的病例，但日本文献中有 11 例 LRLT 后成功妊娠的病例。这些病例表明，LRLT 后妊娠的子痫前期、FGR、早产和剖宫产的发生率与 OLT 后相似，但 LRTL 后妊娠的肝功能障碍和/或胆汁淤积可能比 OLT 后更为常见。
LRLT 后需要密切观察，并应考虑与 OLT 受者相比，LRLT 受者的风险差异。
