Safe pregnancy after liver transplantation: Evidence from a multicenter Italian collaborative study.
作者信息
Sciarrone Salvatore Stefano, Ferrarese Alberto, Bizzaro Debora, Volpato Sofia, Donato Francesca Maria, Invernizzi Federica, Trespidi Laura, Ramezzana Ilaria Giuditta, Avolio Alfonso Wolfango, Nure Erida, Pascale Marco Maria, Fagiuoli Stefano, Pasulo Luisa, Merli Manuela, Lapenna Lucia, Toniutto Pierluigi, Lenci Ilaria, Di Donato Roberto, De Maria Nicola, Villa Erica, Galeota Lanza Alfonso, Marenco Simona, Bhoori Sherrie, Mameli Laura, Cillo Umberto, Boccagni Patrizia, Russo Francesco Paolo, Bo Patrizio, Cosmi Erich, Burra Patrizia
机构信息
Multivisceral Transplant Unit, Department of Surgery Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, Padua 35128, Italy.
Gynaecology and Obstetrics Unit, Department of Women's and Children's Health, University of Padua, Via Giustianini 3, Padua 35128, Italy.
出版信息
Dig Liver Dis. 2022 May;54(5):669-675. doi: 10.1016/j.dld.2021.08.013. Epub 2021 Sep 5.
BACKGROUND
Women who have undergone liver transplantation (LT) enjoy better health, and possibility of childbearing. However, maternal and graft risks, optimal immunosuppression, and fetal outcome is still to clarify.
AIM
Aim of the study was to assess outcomes of pregnancy after LT at national level.
METHODS
In 2019, under the auspices of the Permanent Transplant Committee of the Italian Association for the Study of the Liver, a multicenter survey including 14 Italian LT-centers was conducted aiming at evaluating the outcomes of recipients and newborns, and graft injury/function parameters during pregnancy in LT-recipients.
RESULTS
Sixty-two pregnancies occurred in 60 LT-recipients between 1990 and 2018. Median age at the time of pregnancy was 31-years and median time from transplantation to conception was 8-years. During pregnancy, 4 recipients experienced maternal complications with hospital admission. Live-birth-rate was 100%. Prematurity occurred in 25/62 newborns, and 8/62 newborns had low-birth-weight. Cyclosporine was used in 16 and Tacrolimus in 37 pregnancies, with no different maternal or newborn outcomes. Low-birth-weight was correlated to high values of AST, ALT and GGT.
CONCLUSION
Pregnancy after LT has good outcome; however, maternal complications and prematurity may occur. Compliance with the immunosuppression is fundamental to ensure the stability of graft function and prevent graft-deterioration.
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