Reproductive Health in Liver Transplant Recipients (enduring)-Reproductive Health in Liver Transplant Patients

Video Transcription

Video Summary

The webinar on reproductive health and liver transplant recipients, moderated by Dr. Tatyana Kushner, provides a comprehensive overview from specialists in hepatology. Dr. Avi Stolovitz introduces the session focusing on fertility, contraception, and immunosuppression management for liver transplant recipients. The discussion includes guidance on safe contraceptive options and highlights the importance of preconception counseling. Around 40% of pregnancies in liver transplant recipients are unintended, posing risks such as exposure to teratogenic medications like mycophenolic acid.<br /><br />Dr. Carla Brady discusses immunosuppression, recommending the continuation of calcineurin inhibitors, corticosteroids, and azathioprine during pregnancy, while advising against mycophenolic acid and mTOR inhibitors due to potential teratogenicity. The management of immunosuppression is crucial for stable graft function and optimal pregnancy outcomes. Moreover, trends indicate more transplant recipients are breastfeeding, with medications like calcineurin inhibitors considered safe.<br /><br />Lisa Kassia presents findings from the Transplant Pregnancy Registry International (TPRI), showing favorable maternal and fetal outcomes post-transplant. Challenges include higher rates of intrahepatic cholestasis of pregnancy and preeclampsia. The registry data suggests that planned pregnancies with stable graft function lead to better outcomes. Reproductive assistance methods like IVF have not shown increased graft loss or significant maternal complications.<br /><br />The session underscores the necessity of interdisciplinary management and early involvement of maternal-fetal medicine (MFM) specialists to monitor and ensure healthy pregnancy outcomes in liver transplant recipients. The importance of proactive contraception counseling to prevent unintended pregnancies is also emphasized, aiming to mitigate associated risks.

Keywords

reproductive health

liver transplant

fertility

contraception

immunosuppression

pregnancy outcomes

teratogenic medications

breastfeeding

Transplant Pregnancy Registry

maternal-fetal medicine