Parenthood after liver transplantation.

In conclusion, data from the NTPR support the concept that female liver transplant recipients can safely undergo pregnancy, and male recipients are able to father pregnancies. The true incidence of malformations in both populations needs to be further studied. Female liver recipients have a high rate of premature and low-birth-weight infants. Therefore, pregnancies in the female population must be considered high risk and require close monitoring of liver function. Our data and other reports suggest that altered graft function during pregnancy may represent rejection and must be thoroughly investigated. Data from female CsA kidney recipients and from case reports of liver CsA recipients would suggest that increased doses of CsA may be required during pregnancy. The confounding effects of renal function, hypertension, and combinations of drugs make the interpretation of newborn outcomes and the relationship to immunosuppressive regimens difficult to interpret. To date, an increase in congenital anomalies has not been reported in newborns of liver recipients. Therefore, although subtle effects on reproduction may occur, it seems that favourable pregnancy outcomes can be expected for most liver transplant recipients, but further study is needed as the sample size has been small.