AISF position paper on liver transplantation and pregnancy: Women in Hepatology Group, Italian Association for the Study of the Liver (AISF)

Anna Alisi, Clara Balsano, Veronica Bernabucci, Annalisa Berzigotti, Maurizia Brunetto, Elisabetta Bugianesi, Patrizia Burra, Vincenza Calvaruso, Elisabetta Cariani, Barbara Coco, Isabelle Colle, Rosina Critelli, Eleonora De Martin, Mariagrazia Del Buono, Isabel Fabregat, Francesca Faillaci, Giovanna Fattovich, Annarosa Floreani, Guadalupe Garcia-Tsao, Chantal HoussetAimilia Karampatou, Barbara Lei, Alessandra Mangia, Maria Luz Martinez-Chantar, Fabiola Milosa, Filomena Morisco, Paola Nasta, Tomris Ozben, Teresa Pollicino, Maria Laura Ponti, Patrizia Pontisso, Helen Reeves, Maria Rendina, Kryssia Isabel Rodríguez-Castro, Caterina Sagnelli, Giada Sebastiani, Antonella Smedile, Gloria Taliani, Carmen Vandelli, Ester Vanni, Erica Villa, Ranka Vukotic, Anna Linda Zignego, Patrizia Burra, Kryssia Rodríguez-Castro, Maria Guarino, Filomena Morisco, Erica Villa, Giuseppe Mazzella

Research output: Contribution to journalArticlepeer-review

Abstract

After the first successful pregnancy in a liver transplant recipient in 1978, much evidence has accumulated on the course, outcomes and management strategies of pregnancy following liver transplantation. Generally, liver transplantation restores sexual function and fertility as early as a few months after transplant. Considering that one third of all liver transplant recipients are women, that approximately one-third of them are of reproductive age (18–49 years), and that 15% of female liver transplant recipients are paediatric patients who have a >70% probability of reaching reproductive age, the issue of pregnancy after liver transplantation is rather relevant, and obstetricians, paediatricians, and transplant hepatologists ever more frequently encounter such patients. Pregnancy outcomes for both the mother and infant in liver transplant recipients are generally good, but there is an increased incidence of preterm delivery, hypertension/preeclampsia, foetal growth restriction, and gestational diabetes, which, by definition, render pregnancy in liver transplant recipients a high-risk one. In contrast, the risk of congenital anomalies and the live birth rate are comparable to those of the general population. Currently there are still no robust guidelines on the management of pregnancies after liver transplantation. The aim of this position paper is to review the available evidence on pregnancy in liver transplant recipients and to provide national Italian recommendations for clinicians caring for these patients.

Original languageEnglish
Pages (from-to)860-868
Number of pages9
JournalDigestive and Liver Disease
Volume48
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

Keywords

  • Fertility
  • Immunosuppression
  • Liver transplantation
  • Pregnancy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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