Successful Pregnancy 4 Years After Liver Transplant for Hepatocellular Carcinoma: A Case Report

Abstract

Background

Hepatocellular carcinoma (HCC) is frequently associated with chronic hepatitis and cirrhosis, most commonly affecting men between the ages of 50 and 67. However, certain histological subtypes, such as fibrolamellar HCC, can occur in younger individuals with no gender predilection. Chronic liver disease often leads to amenorrhea and reduced fertility in young women, but liver transplantation has the potential to restore reproductive function. This case report presents a successful pregnancy following liver transplantation for HCC, contributing to the limited literature on pregnancy outcomes in this patient population.

Case Presentation

A 27-year-old woman, gravida 1, with a history of liver transplantation for HCC, presented with a positive pregnancy test. Her liver function remained stable while on immunosuppressive therapy with tacrolimus and everolimus. A multidisciplinary team provided comprehensive care, including regular prenatal monitoring and adjustments to immunosuppressive medications to balance the risk of rejection and fetal health. The patient’s liver function remained stable throughout the pregnancy. Delivery was scheduled at 38 weeks due to fetal growth restriction and borderline amniotic fluid index. Labor induction was attempted, but a cesarean section was performed due to active phase arrest. A healthy infant weighing 2,450 g was delivered, and postpartum follow-up confirmed stable liver function for both mother and child.

Conclusion

This case highlights that successful pregnancy is possible in liver transplant recipients with a history of HCC when appropriate medical management is provided. It underscores the importance of a multidisciplinary approach to optimize maternal and neonatal outcomes. Further studies are warranted to establish standardized guidelines for managing pregnancies in this unique patient population.