Perinatal Outcomes after Liver Transplantation: Is There a Role for Aspirin Treatment?

Autor: Zeevi G; Helen Schneider Hospital for Women, Rabin Medical Center, 39 Jabotinsky St., Petach Tikva 4941492, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, P.O. Box 39040, Tel Aviv 6997801, Israel., Braun M; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, P.O. Box 39040, Tel Aviv 6997801, Israel.; Liver Institute, Rabin Medical Center, 39 Jabotinsky St., Petach Tikva 4941492, Israel., Nesher E; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, P.O. Box 39040, Tel Aviv 6997801, Israel.; Department of Organ Transplantation, Rabin Medical Center, 39 Jabotinsky St., Petach Tikva 4941492, Israel., Wiznitzer A; Helen Schneider Hospital for Women, Rabin Medical Center, 39 Jabotinsky St., Petach Tikva 4941492, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, P.O. Box 39040, Tel Aviv 6997801, Israel., Walfisch A; Helen Schneider Hospital for Women, Rabin Medical Center, 39 Jabotinsky St., Petach Tikva 4941492, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, P.O. Box 39040, Tel Aviv 6997801, Israel., Hadar E; Helen Schneider Hospital for Women, Rabin Medical Center, 39 Jabotinsky St., Petach Tikva 4941492, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, P.O. Box 39040, Tel Aviv 6997801, Israel., Hochberg A; Helen Schneider Hospital for Women, Rabin Medical Center, 39 Jabotinsky St., Petach Tikva 4941492, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, P.O. Box 39040, Tel Aviv 6997801, Israel.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 May 29; Vol. 12 (11). Date of Electronic Publication: 2023 May 29.
DOI: 10.3390/jcm12113733
Abstrakt: Background: We aimed to describe perinatal outcomes and evaluate aspirin treatment effects in liver-transplanted pregnant women.
Methods: A retrospective study examining perinatal outcomes in liver transplant recipients at a single center (2016-2022). The effect of low-dose aspirin treatment on the risk of developing hypertensive disease in these patients was evaluated.
Results: Fourteen deliveries in 11 pregnant liver transplant recipients were identified. Primary liver disease was Wilson's in 50% of pregnancies. The median age was 23 years at transplant and 30 at conception. Tacrolimus was administered in all, steroids in 10 (71.43%), and aspirin (100 mg daily) in 7 (50.0%). Overall, two women (14.28%) developed preeclampsia, and one (7.14%) developed gestational hypertension. Median gestational age at delivery was 37 weeks (31-39 weeks), with six preterm births (between 31-36 weeks) and a median birthweight of 3004 g(range 1450-4100 g). None of those receiving aspirin developed hypertensive disease or suffered excessive bleeding during pregnancy, compared to two (28.57%) with pre-eclampsia in the non-aspirin group.
Conclusion: Liver-transplanted pregnant women comprise a unique and complex patient population with overall favorable pregnancy outcomes. Based on our single-center experience and due to its safety profile and potential benefit, we recommend low-dose aspirin in all liver transplanted patients during pregnancy for preeclampsia prevention. Further large prospective studies are needed to corroborate our findings.
Databáze: MEDLINE
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