Successful Pregnancies in Two Orthotopic Liver Transplant (OLT) Recipients in Iran; Two Case Reports
The patient was a 34-year old woman (G2 P2L2) who suffered from liver failure due to Wilson′s disease. She had orthotopic liver transplant at Namazi Educational Hospital in Shiraz in 2002. After the transplant, liver function was stable and the patient had no rejection episodes or any other complication such as cholestasis.\nConception took place seven years after the operation. This timing had been determined by the transplant team to assure a competent liver function. The patient had a past history of a successful pregnancy before the disease onset and had given birth to a daughter who was 12 at the time of the study.\nThe transplant team was informed about the pregnancy at the end of the 12th week of gestation. The patient had been taking 200mg of Cyclosporine, and 1g of Mycophenolate Mofetil (Cell Cept) per day in the meantime. The Mycophenolate Mofetil intake was terminated and cyclosporine dosage was increased to 300mg per day. Liver function tests and blood concentration of cyclosporine were evaluated periodically. The tests were all normal.\nSonography and gynecological examinations showed a natural fetal growth despite worries about the intake of Mycophenolate Mofetil during the first weeks of pregnancy.\nCaesarean section was performed at the 38th week of pregnancy under general anesthesia on June 2, 2009. The newborn was a healthy girl, weighing 2480g with an Apgar score of 8 at the time of birth. There were no signs of congenital anomalies, structural abnormalities or prematurity in the newborn.