Successful pregnancy in a liver transplant recipient treated with lamivudine for de novo hepatitis B in the graft.
Pregnancy is often successful after liver transplantation, despite the potentially toxic effects of immunosuppressive drug therapy. Liver transplant recipients with recurrent hepatitis C or hepatitis B nonetheless appear to be at risk of a worse graft function in the event of pregnancy, and antiviral drugs are generally contraindicated in pregnancy because of their teratogenic effects. A 33-year-old woman had undergone liver transplantation for Caroli's disease 6 years previously. Two years later the patient experienced de novo HBV hepatitis. Lamivudine treatment (100 mg/day) was started and clearance of HBsAg was documented 1 year later. Four years after starting antiviral treatment the patient became pregnant, despite of the risk of teratogenic effects; lamivudine, cyclosporine and azathioprine were not discontinued for risk of break-through hepatitis and acute or chronic rejection. The course of gestation was uneventful and caesarean section was performed after 36 weeks. The newborn infant was a healthy male weighing 3,080 g and measuring 50 cm.
Loreno
Massimiliano
M
Department of Surgical and Gastroenterological Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
Bo
Patrizio
P
Senzolo
Marco
M
Cillo
Umberto
U
Naoumov
Nikolai
N
Burra
Patrizia
P
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D016767:Caroli Disease / Q000601:surgery; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy* / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D006512:Hepatitis B Core Antigens / Q000032:analysis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D019259:Lamivudine / Q000627:therapeutic use*; D008099:Liver / Q000276:immunology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011256:Pregnancy Outcome; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*
D006512:Hepatitis B Core Antigens; D007166:Immunosuppressive Agents; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D016572:Cyclosporine; D001379:Azathioprine