Liver Transplantation for Acute Liver Failure at 11-Week Gestation with Successful Maternal and Fetal Outcome

Table 2

Review of cases of liver transplantation during pregnancy.

Reference	Diagnosis	Gestational age at transplant	Immunosuppression	Outcome
Morris et al. [20]	Acute liver failure from drug induced liver injury	27 weeks	Prednisone and cyclosporine	Successful deceased donor liver transplant and neonatal death
Laifer et al. [6, 17]	Fulminant Hepatitis B	26 weeks	Prednisone and cyclosporine	Delivery by c section at 28 weeks and neonatal death
Fair et al. [18]	21 y/o woman with acute liver failure from Hepatitis B	22 weeks gestation	Steroids, OKT3, and cyclosporine	Deceased donor liver transplant with primary malfunction, followed by successful retransplantation on postop day 2. C section at 30 weeks. Fetus survived and healthy. Fetus had IUGR and severe oligohydramnios
Moreno et al. [14]	32 y/o female with cryptogenic acute liver failure	27 weeks	Methylprednisolone, cyclosporine, and azathioprine	Successful deceased donor liver transplantation Fetus survived. C-section at 39 weeks. Infant healthy at 11 months
Hamilton et al. [19]	20 y/o woman with acute liver failure from Hepatitis B	18 weeks	n/a	Successful deceased donor liver transplantation. Fetal death on posttransplant day 5
Finlay et al. [22]	Acute liver failure	17 weeks	n/a	Successful deceased donor liver transplantation. Fetal death at 22 weeks
Lo et al. [15]	25 y/o with cryptogenic acute liver failure	26 weeks	n/a	Successful left lobe living donor liver transplantation. Spontaneous abortion posttransplant day 2
Catnach et al. [21]	27 y/o woman with end stage autoimmune hepatitis	20 weeks	Cyclosporine, prednisolone, and azathioprine	Successful deceased donor liver transplantation. Successful delivery at 28 weeks. Recipient developed CMV infection
Laifer et al. [6, 17]	30 y/o female decompensated cirrhosis from autoimmune liver disease	23 weeks	Tacrolimus and prednisone	Fetal death posttransplant day 6
Eguchi et al. [7]	28 y/o woman with cryptogenic acute liver failure	15 weeks	Prednisone and tacrolimus	Successful adult living donor liver transplant. Artificial abortion posttransplant day 31. Recipient developed CMV infection
Kato et al. [8]	31 y/o female with cryptogenic acute liver failure	14 weeks	Methylprednisolone, tacrolimus, and 2 days of mycophenolate mofetil	Left lateral segment adult to adult living donor liver transplantation. Spontaneous abortion immediately after transplant
Jarufe et al. [9]	35 y/o female with cryptogenic acute liver failure	22 weeks	Prednisone and tacrolimus	Successful deceased donor liver transplantation. Delivery at 27 weeks of gestation. Normal psychomotor development at 1-year followup
Jankovic et al. [10]	26 y/o female with cryptogenic familial biliary cirrhosis	13.5 weeks	Tacrolimus, azathioprine, and prednisolone	Successful liver transplantation. Vaginal delivery at 36 weeks
Anders et al. [16]	18 y/o female with cryptogenic acute liver failure	20 weeks	n/a	Successful liver transplantation. Fetal death 48 hours after transplantation
Sequeira et al. [11]	36 y/o female with drug induced acute liver failure due to propylthiouracil	18 weeks	Tacrolimus, cyclosporine, and prednisolone	Successful liver transplantation. Elective cesarean section at 37 weeks. Child had IUGR, oligohydramnios, decreased cerebral volume, ventriculomegaly, microcephaly, seizures, and delayed developmental milestones
Current case	29 y/o female with cryptogenic acute liver failure	11 weeks	Tacrolimus and prednisone	Successful deceased donor liver transplantation. Healthy female fetus delivered at 30 weeks. Normal psychomotor development at 4-year followup