Successful Pregnancies in Two Orthotopic Liver Transplant (OLT) Recipients in Iran; Two Case Reports
The patient was a 31-year old woman (G2 A1l1) who had been suffering from liver failure due to Wilson′s disease. She had undergone orthotopic liver transplant (OLT) at Namazi Educational Hospital in Shiraz in 2002. She had suffered from common bile duct stricture three years after the transplant and had success-fully undergone Endoscopic Retrograde Cholan-giopancreatography (ERCP), balloon dilatation and stenting. During the years after the transplant, the patient had been experiencing episodes of liver enzyme increases which had been treated by medical interventions. The liver function was stable at the time she decided to get pregnant. Mycophenolate Mofetil intake was terminated as soon as the transplant team was informed about her decision and the patient took 200mg of cyclosporine and 5mg of Prednisolone per day.\nThe conception took place 7 years after the transplant. The patient had had a spontaneous abortion three months prior to the present pregnancy.\nAt the time of conception, the patient was under the supervision of a multidisciplinary team of medical experts, including a gastroenterologist, a gynecologist and transplant nurses for the followups, physical examinations and more importantly, consultations. Liver enzymes, bilirubin and cyclosporine concentrations were normal during pregnancy.\nCaesarean section was done at the 38th week of pregnancy by spinal anesthesia on June 30, 2009. The newborn was a boy weighing 3100g with Apgar scores of 8 and 10 at the time of birth and 5 minutes thereafter, respectively. There were no signs of congenital anomalies, structural abnormalities or prematurity in the newborn.