Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 1997 Aug 27;64(4):559-65.
doi: 10.1097/00007890-199708270-00002.

Pregnancy after liver transplantation under tacrolimus

A Jain  1 , R Venkataramanan, J J Fung, J C Gartner, J Lever, V Balan, V Warty, T E Starzl
Affiliations

Pregnancy after liver transplantation under tacrolimus

A Jain et al. Transplantation. .

Abstract

Background: The maternal and fetal risk of pregnancy after organ transplantation under tacrolimus has not been reported. This was prospectively studied in 27 pregnancies by 21 female liver recipients who were treated with tacrolimus before and throughout gestation.

Method: Twenty-seven babies were born between October 1990 and April 1996. In 15 cases, samples were obtained at or after delivery and stored (-40 degrees C) for comparison of tacrolimus concentration in the maternal blood with different combinations of cord and infant venous blood, breast milk, or a section of the placenta.

Results: The 21 mothers had surprisingly few serious complications of pregnancy and no mortality. Two infants with 23 and 24 weeks gestation died shortly after birth. The mean birth weight of the other 25 was 2638+/-781 g after a gestational period of 36.6+/-3.3 weeks. Mean birth weight percentile for gestational age was 50.2+/-26.2 (median 40). On the day of delivery, the mean tacrolimus concentrations (ng/ml) were 4.3 in placenta versus 1.5, 0.7, and 0.5 in maternal, cord, and child plasma, and 0.6 in the first breast milk specimens. The infants had a 36% incidence of transient perinatal hyperkalemia (K+>7.0 meq/L) and a mild reversible renal impairment, which were thought to reflect in part maternal homeostasis. One newborn had unilateral polycystic renal disease (the only anomaly). All 25 babies have had satisfactory postnatal growth and development with a current mean weight percentile of 62+/-37 (median 80).

Conclusions: Pregnancy by postliver transplant mothers under tacrolimus was possible with a surprisingly low incidence of the hypertension, preeclampsia, and other maternal complications historically associated with such gestations. As in previous experience with other immunosuppressive regimens, preterm deliveries were common. However, prenatal growth for gestational age and postnatal infant growth for postpartum age were normal.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A) Birth weight percentile of the newborn, derived from the weight for gestational age nomogram of Lubchenco et al. (8). (B) Gestation period in weeks (solid bar) and birth weight in grams (striped bar) for each newborn baby (*premature baby died).
See this image and copyright information in PMC

Comment in

References

    1. Penn I, Makowski EL, Harris P. Parenthood following renal and hepatic transplantation. Transplantation. 1980;30:397. - PubMed
    1. Scantlebury V, Gordon R, Tzakis A, et al. Childbearing after liver transplantation. Transplantation. 1990;49:317. - PMC - PubMed
    1. Laifer SA, Darby MJ, Scantlebury VP, Harger JH, Caritis SN. Pregnancy and liver transplantation. Obstet Gynecol. 1990;76(6):1083. - PubMed
    1. Radomski JS, Ahlswede BA, Jarrell BE, et al. Outcomes of 500 pregnancies in 335 female kidney, liver, and heart transplant recipients. Transplant Proc. 1995;27(1):1089. - PubMed
    1. Radomski JS, Moritz MJ, Munoz SJ, Cater JR, Jarrell BE, Armenti VT. National Transplantation Pregnancy Registry: analysis of pregnancy outcomes in female liver transplant recipients. Liver Transplant Surg. 1995;1(5):281. - PubMed

Publication types