Successful pregnancy in a liver transplant recipient treated with lamivudine for de novo hepatitis B in the graft

Transpl Int. 2005 Jan;17(11):730-4. doi: 10.1007/s00147-004-0785-5. Epub 2004 Nov 26.

Abstract

Pregnancy is often successful after liver transplantation, despite the potentially toxic effects of immunosuppressive drug therapy. Liver transplant recipients with recurrent hepatitis C or hepatitis B nonetheless appear to be at risk of a worse graft function in the event of pregnancy, and antiviral drugs are generally contraindicated in pregnancy because of their teratogenic effects. A 33-year-old woman had undergone liver transplantation for Caroli's disease 6 years previously. Two years later the patient experienced de novo HBV hepatitis. Lamivudine treatment (100 mg/day) was started and clearance of HBsAg was documented 1 year later. Four years after starting antiviral treatment the patient became pregnant, despite of the risk of teratogenic effects; lamivudine, cyclosporine and azathioprine were not discontinued for risk of break-through hepatitis and acute or chronic rejection. The course of gestation was uneventful and caesarean section was performed after 36 weeks. The newborn infant was a healthy male weighing 3,080 g and measuring 50 cm.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Azathioprine / therapeutic use
  • Caroli Disease / surgery
  • Cyclosporine / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Hepatitis B / drug therapy*
  • Hepatitis B / etiology*
  • Hepatitis B / immunology
  • Hepatitis B / pathology
  • Hepatitis B Core Antigens / analysis
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infant, Newborn
  • Lamivudine / therapeutic use*
  • Liver / immunology
  • Liver Transplantation / adverse effects*
  • Male
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Pregnancy Outcome
  • Reverse Transcriptase Inhibitors / therapeutic use*

Substances

  • Hepatitis B Core Antigens
  • Immunosuppressive Agents
  • Reverse Transcriptase Inhibitors
  • Lamivudine
  • Cyclosporine
  • Azathioprine