title: Pregnancy and orthotopic liver transplantation.
abstract: BACKGROUND
  Sexual and reproductive abnormalities affect up to 50% patients with terminal liver failure. However, these functions recover quickly after orthotopic liver transplantation (OLT). Thus, 80%-90% of OLT women of childbearing age recover menstruation within a few months after transplantation. The aim of our study was to analyze the impact of pregnancy among liver transplant recipients at our center, as well as to analyze the effects of immunosuppression on the fetus.
  
  
  METHODS
  From April 1986 to April 2011, we performed 1500 OLT in 1341 recipients. Among these recipients, 18 patients (1.2%) become pregnant during the follow-up.
  
  
  RESULTS
  The most frequent causes of terminal liver failure were as follows: chronic parenchymal disease (n = 9; 50%), cholestatic disease (n = 3; 16.6%), acute liver failure (n = 5; 27.7%), and metabolic disease (n = 1; 5.5%) The average recipient age at the beginning of pregnancy was 21.2 (±7.3) years. Sixteen patients (88%) became pregnant beyond a year after OLT. The 30 pregnancies in our study resulted in the following: newborns alive (NBA; n = 20; 66.6%) abortions (n = 8; 26.6%) or fetal deaths (n = 2; 6%). The most common immunosuppressant used during pregnancy was tacrolimus (75%) followed by cyclosporine (25%). There were no maternal deaths during pregnancy or the postpartum period.
  
  
  CONCLUSIONS
  We did not observe significant differences between immunosuppression type and maternal complications, pregnancy duration, and childbirth type. Although pregnancy is potential risk, the literature and our results suggest that at a year or more after OLT it usually is safe and successful.
authors.affiliation: Hospital Universitario 12 de Octubre, Surgery, Madrid, Spain. eac.lomba@gmail.com
authors.forename: E
authors.initials: E
authors.lastname: Alvaro
authors.forename: L C
authors.initials: LC
authors.lastname: Jimenez
authors.forename: I
authors.initials: I
authors.lastname: Palomo
authors.forename: A
authors.initials: A
authors.lastname: Manrique
authors.forename: C
authors.initials: C
authors.lastname: Alegre
authors.forename: M
authors.initials: M
authors.lastname: Garcia
authors.forename: I
authors.initials: I
authors.lastname: Justo
authors.forename: M
authors.initials: M
authors.lastname: Abradelo
authors.forename: J
authors.initials: J
authors.lastname: Calvo
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Sesma
authors.forename: F
authors.initials: F
authors.lastname: Cambra
authors.forename: C
authors.initials: C
authors.lastname: Loinaz
authors.forename: E
authors.initials: E
authors.lastname: Moreno
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007231:Infant, Newborn; D016031:Liver Transplantation; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents