Successful pregnancy after 10 consecutive failures in a liver transplant patient with advanced kidney failure

J Nephrol. 2024 Apr;37(3):747-751. doi: 10.1007/s40620-024-01936-5. Epub 2024 May 15.

Abstract

We report a successful, albeit complicated pregnancy with a live-born healthy baby at 28 weeks' gestation, after 10 pregnancy failures, in a 39-year-old patient with a history of liver transplantation and chronic kidney disease with hypertension and proteinuria. Multidisciplinary management (obstetrician, nephrologist and hepatology transplant specialist) allowed close monitoring, adaptation of immunosuppressive treatments and strict control of fetal growth. The onset of preeclampsia at 28 weeks' gestation led to a cesarean section, resulting in the birth of a healthy 830 g boy, with subsequent normal development. Following pregnancy, the patient experienced liver transplant rejection, which resolved after adapting immunosuppressive drugs. No deterioration in kidney function was observed in the year following delivery.

Keywords: Calcineurin inhibitor; Kidney disease; Liver transplant; Preeclampsia; Pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section
  • Female
  • Graft Rejection
  • Humans
  • Immunosuppressive Agents* / therapeutic use
  • Infant, Newborn
  • Kidney Failure, Chronic / surgery
  • Kidney Failure, Chronic / therapy
  • Live Birth
  • Liver Transplantation*
  • Male
  • Pre-Eclampsia
  • Pregnancy
  • Pregnancy Complications*

Substances

  • Immunosuppressive Agents