Zeevi Gil, Braun Marius, Nesher Eviatar, Wiznitzer Arnon, Walfisch Asnat, Hadar Eran, Hochberg Alyssa
Helen Schneider Hospital for Women, Rabin Medical Center, 39 Jabotinsky St., Petach Tikva 4941492, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, P.O. Box 39040, Tel Aviv 6997801, Israel.
J Clin Med. 2023 May 29;12(11):3733. doi: 10.3390/jcm12113733.
We aimed to describe perinatal outcomes and evaluate aspirin treatment effects in liver-transplanted pregnant women.
A retrospective study examining perinatal outcomes in liver transplant recipients at a single center (2016-2022). The effect of low-dose aspirin treatment on the risk of developing hypertensive disease in these patients was evaluated.
Fourteen deliveries in 11 pregnant liver transplant recipients were identified. Primary liver disease was Wilson's in 50% of pregnancies. The median age was 23 years at transplant and 30 at conception. Tacrolimus was administered in all, steroids in 10 (71.43%), and aspirin (100 mg daily) in 7 (50.0%). Overall, two women (14.28%) developed preeclampsia, and one (7.14%) developed gestational hypertension. Median gestational age at delivery was 37 weeks (31-39 weeks), with six preterm births (between 31-36 weeks) and a median birthweight of 3004 g(range 1450-4100 g). None of those receiving aspirin developed hypertensive disease or suffered excessive bleeding during pregnancy, compared to two (28.57%) with pre-eclampsia in the non-aspirin group.
Liver-transplanted pregnant women comprise a unique and complex patient population with overall favorable pregnancy outcomes. Based on our single-center experience and due to its safety profile and potential benefit, we recommend low-dose aspirin in all liver transplanted patients during pregnancy for preeclampsia prevention. Further large prospective studies are needed to corroborate our findings.
我们旨在描述肝移植孕妇的围产期结局，并评估阿司匹林治疗效果。
一项回顾性研究，调查单一中心（2016 - 2022年）肝移植受者的围产期结局。评估低剂量阿司匹林治疗对这些患者发生高血压疾病风险的影响。
确定了11例肝移植孕妇的14次分娩。50%的妊娠原发性肝病为威尔逊氏病。移植时的中位年龄为23岁，受孕时为30岁。所有患者均使用他克莫司，10例（71.43%）使用类固醇，7例（50.0%）使用阿司匹林（每日100毫克）。总体而言，两名女性（14.28%）发生先兆子痫，一名（7.14%）发生妊娠期高血压。分娩时的中位孕周为37周（31 - 39周），有6例早产（31 - 36周之间），中位出生体重为3004克（范围1450 - 4100克）。与非阿司匹林组中两名（28.57%）发生先兆子痫的患者相比，接受阿司匹林治疗的患者在孕期均未发生高血压疾病或出现大量出血。
肝移植孕妇是一个独特且复杂的患者群体，总体妊娠结局良好。基于我们的单中心经验，鉴于其安全性和潜在益处，我们建议在所有肝移植患者孕期使用低剂量阿司匹林以预防先兆子痫。需要进一步的大型前瞻性研究来证实我们的发现。
