Pregnancy After Liver Transplant - A Case Report In The Context Of Hepatic Transplant At Reproductive Age Romanian Achievements

Pregnancy amid patients with chronic liver disease presents a unique management features for both mother and fetus. The peak of incidence of the chronic liver diseases is in infertile old age. Due to fertility consequences, pregnancy is unusual in women with severe chronic liver disease. High risk pregnancies associated to liver transplant in young women require special monitoring of hepatic function and fetal development, taking into account the increased incidence of preterm delivery due to pregnancy induced hypertension and episodes of graft rejection, early onset preeclampsia related to the baseline renal dysfunction and use of immunosuppressive therapy, fetal growth restriction, gestational diabetes and stillbirths. We present the case of a 26 years old patient with chronic HBV and HDV infection and the evolution of her pregnancy. The patient was diagnosed at the age 13 with chronic viral infection and over the next year she reached the stage of liver cirrhosis of viral etiology, decompensated portal and parenchymal, Child B stage and was included on the waiting list for liver transplantation. The liver transplantation living related with right lobe was performed at Fundeni Clinical Institute, having as a donor the mother of the patient. Post-surgery evolution was favorable and uneventful. The physiological pregnancy occurred at age 25, and under continuous administration of post transplantation immunosuppressive medication, had an uncomplicated outcome. The patient gave birth by term-programmed caesarean section, to a living normal weight fetus with negative markers for viral hepatitis. We discuss the reported case in the context of o a series of successfully liver transplantations cases performed at young ages at Fundeni Clinical Institute.