Successful outcome after a technically challenging liver transplant during pregnancy.
Little is known about the implications of liver transplantation (OLT) during pregnancy. We report the case of a 26-year-old woman with cryptogenic familial biliary cirrhosis that decompensated rapidly. OLT was performed using the donor iliac vein for a retrogastric portal vein conduit to the superior mesenteric vein and the donor iliac artery for an infrarenal aortic conduit. During the latter anastomosis, a viable fetus was noticed. Both donor and recipient were cytomegalovirus positive. Postoperative ultrasound revealed a 13.5-week-old viable fetus. The patient received tacrolimus, azathioprine, and prednisolone. The pregnancy progressed normally with the vaginal delivery of a healthy male infant after 36 weeks gestation. Nineteen months later, both the mother and child were well. This case demonstrated that even technically difficult OLT during pregnancy can have a successful outcome, raising the question of whether transplant patients of childbearing age should be routinely tested for pregnancy.
Jankovic
Z
Z
Department of Anesthesia, St. James University Hospital, Leeds, West Yorkshire, United Kingdom. zorica.jankovic@leedsth.nhs.uk
Stamenkovic
D
D
Duncan
B
B
Prasad
R
R
Davies
M
M
D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008105:Liver Cirrhosis, Biliary / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D016896:Treatment Outcome