Document Detail

Pregnancy outcomes in liver transplant recipients: A systematic review and meta-analysis.
MedLine Citation:
PMID:  22344967     Owner:  NLM     Status:  Publisher    
Approximately 14,000 women of reproductive age in the US are currently living after liver transplantation (LT), and another 500 undergo LT each year. Although LT improves reproductive function in women with advanced liver disease, the associated pregnancy outcomes and maternal-fetal risks have not been quantified in a broad manner. To obtain more generalizable inferences, we performed a systematic review and meta-analysis of articles published between 2000-2011 that reported pregnancy-related outcomes among LT recipients. Of 578 unique studies, 8 met inclusion criteria, representing 450 pregnancies in 306 LT recipients. Post-LT live birth rate (76.9%; 95%CI 72.7-80.7) was higher than the general US population (66.7%) but similar to post-KT (73.5%). Post-LT miscarriage rate (15.6%; 95%CI 12.3-19.2) was lower than the general population (17.1%) but similar to post-KT (14.0%). Pre-eclampsia (21.9%, 95%CI 17.7-26.4), Cesarean section (44.6%, 95%CI 39.2-50.1), and preterm delivery (39.4%, 95% CI 33.1-46.0) were higher than the general US population (3.8%, 31.9%, and 12.5%, respectively), but lower than post-KT (27.0%, 54.2%, and 45.6%). Both mean gestational age and mean birth weight were significantly greater in LT than in KT recipients (36.5 weeks vs. 35.6 weeks, and 2866 grams vs. 2420 grams). Although post-LT pregnancy is feasible, complication rates are relatively high and should be considered in patient counseling and clinical decision-making. More case and center reports are necessary to gather information on post-LT pregnancy outcomes and complications in order to improve clinical management of pregnant LT recipients. Continued reporting to active registries is highly encouraged at the center level. Liver Transpl, 2012. © 2012 AASLD.
Neha A Deshpande; Nathan T James; Lauren M Kucirka; Brian J Boyarsky; Jacqueline M Garonzik-Wang; Andrew M Cameron; Andrew L Singer; Nabil N Dagher; Dorry L Segev
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-17
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  -     ISSN:  1527-6473     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Association for the Study of Liver Diseases.
Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
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