title: Pregnancy after liver transplantation.
abstract: Women constitute >30% of patients undergoing liver transplantation (orthotopic liver transplantation, OLT) and about 8% are of reproductive age, and 5% are pediatric females who will mostly survive into adulthood and will consider pregnancy. Although pregnancy in OLT recipients is associated with an increased incidence of hypertension, preeclampsia, anemia, preterm deliveries, and cesarean section, acute rejection and liver allograft loss do not appear to be increased and pregnancy-related maternal death is uncommon. The incidence of structural malformations in the newborn of liver transplant recipients is reported to be 4.4%, which is similar to the rate of 3-5% in the US general population. Patients are advised to defer conception for at least 1-2 years after OLT, while maintaining effective contraception. Pregnancy after OLT usually results in a favorable maternal and neonatal outcome when there is coordinated pre- and perinatal care by a multidisciplinary team composed of obstetric-gynecologists, and a transplant team.
authors.affiliation: Thomas Jefferson University, 605 College Bldg., 1025 Walnut St., Philadelphia, PA 19107, USA. Electronic address: carlo.ramirez@jefferson.edu.
authors.forename: Carlo B
authors.initials: CB
authors.lastname: Ramirez
authors.affiliation: Thomas Jefferson University, 605 College Bldg., 1025 Walnut St., Philadelphia, PA 19107, USA.
authors.forename: Cataldo
authors.initials: C
authors.lastname: Doria
mesh_terms: D002585:Cesarean Section / Q000401:mortality; D019317:Evidence-Based Medicine; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D015994:Incidence; D007231:Infant, Newborn; D033183:Interdisciplinary Communication; D016031:Liver Transplantation / Q000401:mortality; D015201:Meta-Analysis as Topic; D011225:Pre-Eclampsia / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D011256:Pregnancy Outcome; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
keywords: acute rejection; immunosuppression; liver cirrhosis; liver transplantation; maternal and neonatal outcomes; pregnancy