Successful pregnancy and delivery after split liver transplantation: A case report and literature review

Abstract

Objective To investigate the experience in the clinical management of pregnancy and delivery after split liver transplantation (SLT). Methods Related clinical data were collected from a patient who became pregnant and delivered successfully after SLT in the Organ Transplantation Center of our hospital, and a literature review was also performed. Results The patient underwent allogeneic orthotopic SLT due to decompensated liver cirrhosis after autoimmune hepatitis and developed mild acute rejection after surgery, which was improved after the adjustment of immunosuppressive drugs. The patient became pregnant spontaneously at 2 years after surgery, and due to the medication history of mycophenolate sodium enteric-coated tablets, she decided to terminate pregnancy and withdraw from this drug. The patient became pregnant again at 3 years after surgery and expe-rienced fluctuations in graft function, and a series of treatments were given, such as adjustment of the dose of anti-rejection drugs, liver-protecting symptomatic treatment, and tocolytic therapy for threatened preterm labor. Finally under the guidance of liver transplantation, obstetrics, and neonatology, the patient gave birth to a healthy girl by cesarean section at 35 weeks of gestation. Conclusion Although SLT recipients may experience the situations such as fluctuations in graft function and preterm birth, they can achieve a satisfactory prognosis under multidisciplinary collaboration, scientific medication guidance, and close follow-up monitoring.

Keywords

• liver transplantation|prognosis|pregnancy|immunosuppressive agents|graft rejection|hepatic insufficiency