Higashi H, Obara H, Miyakoshi K, Shinoda M, Kitago M, Shimojima N, Abe Y, Hibi T, Yagi H, Matsubara K, Yamada Y, Itano O, Hoshino K, Kuroda T, Kitagawa Y. First successful perinatal management of pregnancy after ABO-incompatible liver transplantation. World J Gastroenterol 2017; 23(3): 547-550 [PMID: 28210092 DOI: 10.3748/wjg.v23.i3.547]
Corresponding Author of This Article
Hideaki Obara, MD, PhD, FACS, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. obara.z3@keio.jp
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hisanobu Higashi, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
Kei Miyakoshi, Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
Naoki Shimojima, Yohei Yamada, Ken Hoshino, Tatsuo Kuroda, Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
Author contributions: Higashi H and Obara H wrote the paper; Miyakoshi K followed and treated the patient during pregnancy; all other members contributed equally to the medical treatment.
Institutional review board statement: The study was reviewed and approved by the Keio University School of Medicine Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hideaki Obara, MD, PhD, FACS, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. obara.z3@keio.jp
Telephone: +81-333531211 Fax: +81-333554707
Received: August 31, 2016 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
Abstract
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.
