title: First successful perinatal management of pregnancy after ABO-incompatible liver transplantation.
abstract: Many papers have reported on pregnancy and delivery after liver transplantation, but there have been no reports on pregnancy after ABO-incompatible liver transplantation. This paper reports the first successful pregnancy and delivery of a newborn after ABO-incompatible liver transplantation for fulminant hepatic failure. The patient was a 39-year-old female. She had an ABO-incompatible liver transplantation, donated from her husband, due to subacute fulminant hepatitis of unknown etiology. She was taking tacrolimus, methylprednisolone, and mizoribine orally for the maintenance of immunosuppression at the time of discharge. She was discharged uneventfully on postoperative day 38 without any rejection episodes. At 1 year and 6 mo after transplantation, she indicated a wish to become pregnant. Therefore, treatment with mycophenolate mofetil was interrupted at that time. After two miscarriages, she finally became pregnant and delivered transvaginally 3 years after the transplantation. All of the pregnancies were conceived naturally. The newborn was female with a birth weight of 3146 g; the Apgar scores were 9 and 10. Delivery was performed smoothly, and the newborn exhibited no malformations. The mother and the newborn were discharged uneventfully. We suggest that pregnancy is possible for recipients after ABO-incompatible liver transplantation.
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Higashi
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Obara
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Miyakoshi
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shinoda
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kitago
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Shimojima
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Taizo
authors.initials: T
authors.lastname: Hibi
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagi
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Matsubara
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Itano
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Hoshino
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kuroda
authors.affiliation: Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000017:ABO Blood-Group System / Q000009:adverse effects*; D000284:Administration, Oral; D000328:Adult; D001034:Apgar Score; D001706:Biopsy; D001787:Blood Group Incompatibility / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D036861:Delivery, Obstetric; D005260:Female; D017583:Hemodiafiltration; D006501:Hepatic Encephalopathy / Q000097:blood / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006505:Hepatitis / Q000150:complications*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007231:Infant, Newborn; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D012263:Ribonucleosides / Q000008:administration & dosage / Q000627:therapeutic use; D000069283:Rituximab / Q000008:administration & dosage / Q000627:therapeutic use; D018454:Spouses; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents; D012263:Ribonucleosides; D000069283:Rituximab; C010052:mizoribine; D016559:Tacrolimus; D008775:Methylprednisolone
keywords: ABO-incompatible; Delivery; Fulminant hepatic failure; Liver transplantation; Living donor; Pregnancy