Background: Women who have undergone liver transplantation (LT) enjoy better health, and possibility of childbearing. However, maternal and graft risks, optimal immunosuppression, and fetal outcome is still to clarify. Aim: Aim of the study was to assess outcomes of pregnancy after LT at national level. Methods: In 2019, under the auspices of the Permanent Transplant Committee of the Italian Association for the Study of the Liver, a multicenter survey including 14 Italian LT-centers was conducted aiming at evaluating the outcomes of recipients and newborns, and graft injury/function parameters during pregnancy in LT-recipients. Results: Sixty-two pregnancies occurred in 60 LT-recipients between 1990 and 2018. Median age at the time of pregnancy was 31-years and median time from transplantation to conception was 8-years. During pregnancy, 4 recipients experienced maternal complications with hospital admission. Live-birth-rate was 100%. Prematurity occurred in 25/62 newborns, and 8/62 newborns had low-birth-weight. Cyclosporine was used in 16 and Tacrolimus in 37 pregnancies, with no different maternal or newborn outcomes. Low-birth-weight was correlated to high values of AST, ALT and GGT. Conclusion: Pregnancy after LT has good outcome; however, maternal complications and prematurity may occur. Compliance with the immunosuppression is fundamental to ensure the stability of graft function and prevent graft-deterioration.

Safe pregnancy after liver transplantation: Evidence from a multicenter Italian collaborative study / Sciarrone, S. S.; Ferrarese, A.; Bizzaro, D.; Volpato, S.; Donato, F. M.; Invernizzi, F.; Trespidi, L.; Ramezzana, I. G.; Avolio, A. W.; Nure, E.; Pascale, M. M.; Fagiuoli, S.; Pasulo, L.; Merli, M.; Lapenna, L.; Toniutto, P.; Lenci, I.; Di Donato, R.; De Maria, N.; Villa, E.; Galeota Lanza, A.; Marenco, S.; Bhoori, S.; Mameli, L.; Cillo, U.; Boccagni, P.; Russo, F. P.; Bo, P.; Cosmi, E.; Burra, P.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - (2021). [10.1016/j.dld.2021.08.013]

Safe pregnancy after liver transplantation: Evidence from a multicenter Italian collaborative study

Merli M.
Writing – Review & Editing
;
Lapenna L.;
2021

Abstract

Background: Women who have undergone liver transplantation (LT) enjoy better health, and possibility of childbearing. However, maternal and graft risks, optimal immunosuppression, and fetal outcome is still to clarify. Aim: Aim of the study was to assess outcomes of pregnancy after LT at national level. Methods: In 2019, under the auspices of the Permanent Transplant Committee of the Italian Association for the Study of the Liver, a multicenter survey including 14 Italian LT-centers was conducted aiming at evaluating the outcomes of recipients and newborns, and graft injury/function parameters during pregnancy in LT-recipients. Results: Sixty-two pregnancies occurred in 60 LT-recipients between 1990 and 2018. Median age at the time of pregnancy was 31-years and median time from transplantation to conception was 8-years. During pregnancy, 4 recipients experienced maternal complications with hospital admission. Live-birth-rate was 100%. Prematurity occurred in 25/62 newborns, and 8/62 newborns had low-birth-weight. Cyclosporine was used in 16 and Tacrolimus in 37 pregnancies, with no different maternal or newborn outcomes. Low-birth-weight was correlated to high values of AST, ALT and GGT. Conclusion: Pregnancy after LT has good outcome; however, maternal complications and prematurity may occur. Compliance with the immunosuppression is fundamental to ensure the stability of graft function and prevent graft-deterioration.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/1576717
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