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

Salvatore Stefano Sciarrone, Alberto Ferrarese, Debora Bizzaro, Sofia Volpato, Francesca Maria Donato, Federica Invernizzi, Laura Trespidi, Ilaria Giuditta Ramezzana, Alfonso Wolfango Avolio, Erida Nure, Marco Maria Pascale, Stefano Fagiuoli, Luisa Pasulo, Manuela Merli, Lucia Lapenna, Pierluigi Toniutto, Ilaria Lenci, Roberto Di Donato, Nicola De Maria, Erica VillaAlfonso Galeota Lanza, Simona Marenco, Sherrie Bhoori, Laura Mameli, Umberto Cillo, Patrizia Boccagni, Francesco Paolo Russo, Patrizio Bo, Erich Cosmi, Patrizia Burra

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
JournalDigestive and Liver Disease
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Immunosuppression
  • Infertility
  • Liver transplantation
  • Pregnancy outcomes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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