Second successful pregnancy following liver transplantation

Abstract

Liver transplantation for end stage liver disease, offers the recipient a near normal life, including pregnancies for women. Successful pregnancies have been reported, but successful second pregnancies are rare. We present our patient with a second successful pregnancy following her liver transplantation. A 22-year-old living donor liver transplant (LT) recipient was enrolled in our unit for antenatal care of her second pregnancy. Her native liver had failed due to autoimmune hepatitis. She had her first planned pregnancy at 19 months post-transplant. The second pregnancy was a spontaneous conception a year later. The obstetric parameters were normal, but she developed signs of suspected graft rejection and hence an emergency cesarean section was done. A preterm baby was delivered with a good APGAR score. The baby was treated in neonatal intensive unit for four days. The mother recovered well and the liver parameters normalized on the sixth postoperative day. Liver transplantation restores fertility in transplant recipients. Pregnancy, the liver graft and the associated medications have a complex interplay. Post LT pregnancy outcome can be optimized with a multidisciplinary approach. Better understanding and close monitoring is essential for a successful outcome.