Introduction: Thanks to advances in surgical techiques and immunosuppression, patient and graft survival after organ transplantation have increased significantly. Most of the female patients who had liver and kidney transplants in childhood want to become pregnant when they reach reproductive age. Among this patients, concerns regarding adverse immunosuppression effect on the fetus and consequence of pregnancy of allograft function represent significant sources of anxiety. We retrospectively analyzed pregnancy outcomes after liver and kidney transplantation at our transplant center.
Material and Methods: Since November 3, 1975 we have performed 3630 kidney transplantations (KT) and 776 liver transplantations (LT) at Baskent University. Among KT recipients 428 were pediatric and 377 of LT patients were pediatric (age <18 years old). On March 15, 1990, Dr. Haberal performed partial LT in children, a first in Turkey, Europe and the region. Mean age of the pediatric KT recipients was 13.8 ± 6.7 (range 1.5-18 years) and of the pediatric LT recipients was 7.44 years (range 4 months – 17 years). Of 428 pediatric kidney transplant patients 197 were female and 156 of 368 pediatric LT patients were female. All of KT and LT’s were living related kidney transplant and all recipients were relatives with their donors.
Results: In total, Twenty-eight recipients who underwent liver or kidney transplantation as pediatric patients became pregnant as adults. Of these patients, 10 were LT recipients and 18 were KT recipients. The mean age at which the patients gave birth was 30 years (range 24-38 years). The mean time between the organ transplantation and delivery of the patients was 10.63 years (range 2-22 years). Recipient patients were immunosuppressed with tacrolimus or cyclosporine together with prednisone during pregnancy. The mean delivery time of the babies was 35.5 weeks (range 24-39 weeks). One patient delivered vaginally, and the other patients delivered by cesarean section. Except for 1 baby, all of the other babies were born healthy. One baby died at 24 weeks due to placenta previa. No significant complications or organ rejection occurred during or after delivery in any of the mothers.
Conclusion: The successful transition from childhood to adulthood in liver and kidney transplant recipients underscores the critical role of organ transplantation in preserving long-term health and enabling a fulfilling life. These life-saving procedures not only restore essential organ function but also provide patients with the opportunity to lead healthy, productive lives, including the ability to have a healthy pregnancy. The positive reproductive outcomes in these patients reflect the effectiveness of timely and well-managed transplants. Ensuring a smooth transition to adulthood is essential for optimizing both health and quality of life for transplant recipients.