Published online Jan 21, 2017. doi: 10.3748/wjg.v23.i3.547
Peer-review started: September 1, 2016
First decision: September 28, 2016
Revised: October 7, 2016
Accepted: November 12, 2016
Article in press: November 12, 2016
Published online: January 21, 2017
Processing time: 135 Days and 22.4 Hours
Many papers have reported on pregnancy and delivery after liver transplantation, but there have been no reports on pregnancy after ABO-incompatible liver transplantation. This paper reports the first successful pregnancy and delivery of a newborn after ABO-incompatible liver transplantation for fulminant hepatic failure. The patient was a 39-year-old female. She had an ABO-incompatible liver transplantation, donated from her husband, due to subacute fulminant hepatitis of unknown etiology. She was taking tacrolimus, methylprednisolone, and mizoribine orally for the maintenance of immunosuppression at the time of discharge. She was discharged uneventfully on postoperative day 38 without any rejection episodes. At 1 year and 6 mo after transplantation, she indicated a wish to become pregnant. Therefore, treatment with mycophenolate mofetil was interrupted at that time. After two miscarriages, she finally became pregnant and delivered transvaginally 3 years after the transplantation. All of the pregnancies were conceived naturally. The newborn was female with a birth weight of 3146 g; the Apgar scores were 9 and 10. Delivery was performed smoothly, and the newborn exhibited no malformations. The mother and the newborn were discharged uneventfully. We suggest that pregnancy is possible for recipients after ABO-incompatible liver transplantation.
Core tip: This report is on the first successful perinatal management of pregnancy after ABO-incompatible liver transplantation. We suggest that pregnancy should be allowed for those who previously received ABO-incompatible liver transplantation.