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Pregnancy in Liver Transplantation

Research output: Contribution to journalReview article

Mussarat N. Rahim, Lisa Long, Leonie Penna, Catherine Williamson, Nikos A. Kametas, Kypros H. Nicolaides, Michael A. Heneghan

Original languageEnglish
Pages (from-to)564-581
Number of pages18
JournalLiver Transplantation
Volume26
Issue number4
DOIs
Publication statusPublished - 1 Apr 2020

King's Authors

Abstract

Pregnancy after liver transplantation (LT) is increasingly common and is a frequent scenario that transplant physicians, obstetricians, and midwives encounter. This review summarizes the key issues surrounding preconception, pregnancy-related outcomes, immunosuppression, and breastfeeding in female LT recipients. Prepregnancy counseling in these patients should include recommendations to delay conception for at least 1-2 years after LT and discussions about effective methods of contraception. Female LT recipients are generally recommended to continue immunosuppression during pregnancy to prevent allograft rejection; however, individual regimens may need to be altered. Although pregnancy outcomes are overall favorable, there is an increased risk of maternal and fetal complications. Pregnancy in this cohort remains high risk and should be managed vigilantly in a multidisciplinary setting. We aim to review the available evidence from national registries, population-based studies, and case series and to provide recommendations for attending clinicians.

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