title: Outcome of four high-risk pregnancies in female liver transplant recipients on tacrolimus immunosuppression.
abstract: Pregnancies in women after liver transplantation are considered high risk due to the greater rate of complications observed in immunosuppressed graft recipients. We report successful outcomes of four high-risk pregnancies in female liver transplant recipients on tacrolimus-based immunosuppression. The patients, aged 23 to 32 years, at the time of conception were 12 to 59 months from transplantation (mean 30 months). Preterm labor was the most important pregnancy complication observed in these patients. One episode of acute graft rejection was observed. A variable demand for tacrolimus was noted during pregnancy. Despite complications all four pregnancies were successful. The mean gestational age at delivery was 34.4 weeks. The birth weight of the newborns varied from 1410 to 3490 g (mean 2303 g) and the mean Apgar score was 8. No structural malformations or early complications were observed in the newborns. Excluding the patient with acute rejection, the remaining three cases showed all liver parameters to remain stable.
authors.affiliation: First Department of Obstetrics and Gynecology, Warsaw Medical University, Pl. Starynkiewicza 1/3, 02-015 Warsaw, Poland.
authors.forename: Z
authors.initials: Z
authors.lastname: Jabiry-Zieniewicz
authors.forename: P
authors.initials: P
authors.lastname: Kamiński
authors.forename: B
authors.initials: B
authors.lastname: Pietrzak
authors.forename: A
authors.initials: A
authors.lastname: Cyganek
authors.forename: K
authors.initials: K
authors.lastname: Bobrowska
authors.forename: J
authors.initials: J
authors.lastname: Ziółkowski
authors.forename: U
authors.initials: U
authors.lastname: Ołdakowska-Jedynak
authors.forename: K
authors.initials: K
authors.lastname: Zieniewicz
authors.forename: L
authors.initials: L
authors.lastname: Paczek
authors.forename: I
authors.initials: I
authors.lastname: Jankowska
authors.forename: M
authors.initials: M
authors.lastname: Wielgoś
authors.forename: M
authors.initials: M
authors.lastname: Krawczyk
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology*; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011256:Pregnancy Outcome; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus