Challenge and progress of pregnancy after liver transplantation

doi:10.3877/cma.j.issn.1674-3903.2022.02.012

Abstract

Abstract:

Liver transplantation is the most effective treatment for end-stage liver diseases. With the advances in surgical techniques and perioperative managements, the prognosis of liver transplantation recipients has been improved remarkably. The increasing number of women of reproductive age and girls who underwent liver transplantation raised the importance of potential reproductive needs in the long-term postoperative survival. However, owing to the increased risk of complication in pregnancy, fetal anomalies and graft status, pregnancy after liver transplantation is more complicated than normal pregnancy. Considering the importance in the long-term management of liver transplantation recipients, it is necessary to incorporate the pregnancy after liver transplantation into standardized clinical diagnosis and treatment system. Here, aiming to elevate the cognition and attention of pregnancy after liver transplantation in clinical practice, this review examined the domestic and overseas research results, and comprehensively elucidated the progress of pregnancy after liver transplantation.

Key words: Liver transplantation, Pregnancy, Immunosuppression

Yiru Wang, Xinyu Yang, Zheng Niu, Liping Sun, Xiao Xu. Challenge and progress of pregnancy after liver transplantation[J]. Chinese Journal of Transplantation(Electronic Edition), 2022, 16(02): 119-121.

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References 33

1	Dokmak A, Trivedi HD, Bonder A, et al. Pregnancy in chronic liver disease: before and after transplantation[J]. Ann Hepatol, 2021, 26: 100557.
2	Rahim MN, Theocharidou E, Yen Lau KG, et al. Safety and efficacy of in vitro fertilisation in patients with chronic liver disease and liver transplantation recipients[J]. J Hepatol, 2021, 74(6): 1407-1415.
3	Jabiry-Zieniewicz Z, Szpotanska-Sikorska M, Pietrzak B, et al. Pregnancy outcomes among female recipients after liver transplantation: further experience[J]. Transplant Proc, 2011, 43(8): 3043-3047.
4	Walcott WO, Derick DE, Jolley JJ, et al. Successful pregnancy in a liver transplant patient[J]. Am J Obstet Gynecol, 1978, 132(3): 340-341.
5	Christopher V, Al-Chalabi T, Richardson PD, et al. Pregnancy outcome after liver transplantation: a single-center experience of 71 pregnancies in 45 recipients[J]. Liver Transpl, 2006，12(7)：1138-1143.
6	Mattila M, Kemppainen H, Isoniemi H, et al. Pregnancy outcomes after liver transplantation in Finland[J]. Acta Obstet Gynecol Scand, 2017, 96(9): 1106-1111.
7	Coelho JCU, Parolin MB, Matias JEF. Successful twin pregnancy after orthotopic liver transplantation[J]. Arq Gastroenterol, 2002, 39(4): 246-247.
8	Sarkar M, Sawinski D, Coscia L, et al. Pregnancy in liver transplantation[J]. Liver Transpl, 2020, 26(7): 954-955.
9	Marzec I, Sowakiewicz A, Gozdowska J, et al. Pregnancy after liver transplant: maternal and perinatal outcomes[J]. BMC Pregnancy and Childbirth, 2021, 21(1): 627.
10	Coffin CS, Shaheen AAM, Burak KW, et al. Pregnancy outcomes among liver transplant recipients in the United States: a nationwide case-control analysis[J]. Liver Transpl, 2010, 16(1): 56-63.
11	Baskiran A, Karakas S, Ince V, et al. Pregnancy after liver transplantation: risks and outcomes[J]. Transplant Proc, 2017, 49(8): 1875-1878.
12	Westbrook RH, Yeoman AD, Agarwal K, et al. Outcomes of pregnancy following liver transplantation: The King's College Hospital experience[J]. Liver Transpl, 2015, 21(9): 1153-1159.
13	Prodromidou A, Kostakis ID, Machairas N, et al. Pregnancy outcomes after liver transplantation: a systematic review[J]. Transplant Proc, 2019, 51(2): 446-449.
14	Marson EJ, Kamarajah SK, Dyson JK, et al. Pregnancy outcomes in women with liver transplants: systematic review and meta-analysis[J]. HPB (Oxford), 2020, 22(8): 1102-1111.
15	Valentin N, Guerrido I, Rozenshteyn F, et al. Pregnancy outcomes after liver transplantation: a systematic review and meta-analysis[J]. Am J Gastroenterol, 2021, 116(3): 491-504.
16	European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu. EASL clinical practice guidelines: liver transplantation [J]. J Hepatol，2016, 64(2)：433-485.
17	Armenti VT, Constantinescu S, Moritz MJ, et al. Pregnancy after transplantation[J]. Transplant Rev (Orlando), 2008, 22(4): 223-240.
18	Kainz A, Harabacz I, Cowlrick IS, et al. Review of the course and outcome of 100 pregnancies in 84 women treated with tacrolimus[J]. Transplantation, 2000, 70(12): 1718-1721.
19	Naya I, Sanada Y, Katano T, et al. Pregnancy outcomes following pediatric liver transplantation: a single-center experience in Japan[J]. Ann Transplant, 2020, 25: e921193.
20	Women in Hepatology Group; Italian Association for the Study of the Liver (AISF). ISF position paper on liver transplantation and pregnancy: Women in Hepatology Group, Italian Association for the Study of the Liver (AISF)[J]. Dig Liver Dis, 2016, 48(8): 860-868.
21	Sifontis NM, Coscia LA, Constantinescu S, et al. Pregnancy outcomes in solid organ transplant recipients with exposure to mycophenolate mofetil or sirolimus[J]. Transplantation, 2006, 82(12): 1698-1702.
22	Sawas T, Simonetto DA. Should pregnancy after liver transplantation bring joy or fear？[J]. Clin Gastroenterol Hepatol, 2019, 17(7): 1251-1252.
23	中国医师协会器官移植医师分会，中华医学会器官移植学分会肝移植学组. 中国肝移植受者代谢病管理专家共识(2019版)[J/CD]. 中华移植杂志：电子版，2019, 13(3): 187-194.
24	Zhang C, Chen K, Wei R, et al. The circFASN/miR-33a pathway participates in tacrolimus-induced dysregulation of hepatic triglyceride homeostasis[J]. Signal Transduct Target Ther, 2020, 5(1): 23.
25	Dbrowski F, Kobryń E, Jarmużek P, et al. Pregnancy weight gain as a predictor of fetal wellbeing in liver transplant recipients[J]. Ann Transplant, 2020, 25: e923804.
26	Deshpande NA, James NT, Kucirka LM, et al. Pregnancy outcomes of liver transplant recipients: a systematic review and meta-analysis[J]. Liver Transpl, 2012, 18(6): 621-629.
27	Kallapur A, Jang C, Yin O, et al. Pregnancy care in solid organ transplant recipients[J]. Int J Gynaecol Obstet, 2022, 157(3): 502-513.
28	Nure E, Pascale MM, Frongillo F, et al. Pregnancy after liver transplant: neonatal outcomes and long-term maternal follow-up[J]. Transplant Proc, 2019, 51(9): 2948-2951.
29	Mohamed-Ahmed O, Nelson-Piercy C, Bramham K, et al. Pregnancy outcomes in liver and cardiothoracic transplant recipients: a UK national cohort study[J]. PLoS One, 2014, 9(2): e89151.
30	López-Cepero R, de la Vega A, Lynch L. Pregnancy after liver transplantation[J]. Bol Asoc Med P R, 2013, 105(1): 9-13.
31	Deputy NP, Kim SY, Conrey EJ, et al. Prevalence and changes in preexisting diabetes and gestational diabetes among women who had a live birth - United States, 2012-2016[J]. MMWR Morb Mortal Wkly Rep, 2018, 67(43): 1201-1207.
32	Constantinescu S, Pai A, Coscia LA, et al. Breast-feeding after transplantation[J]. Best Pract Res Clin Obstet Gynaecol, 2014, 28(8): 1163-1173.
33	Shah S, Verma P. Overview of pregnancy in renal transplant patients[J]. Int J Nephrol, 2016, 2016: 4539342.

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[14]	Menglong Wang. Significance of biological characteristics in liver transplantation for HCC [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(05): 490-494.
[15]	Yuyan Zhang, Bin Hu, Weihong Zhang, Mei Xu, Hui Zhu, Xinyue Yang, Hailing Liu. Relationship between echocardiography parameters and liver function during the second trimester of pregnancy and their predictive value for adverse pregnancy outcomes [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 499-504.

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