2016 Volume 52 Issue 5 Pages 1103-1107
A 25-year-old woman with biliary atresia after portoenterostomy, who was married and wished to give birth, visited our institution. She had compensated cirrhosis and large jejunoileal varices, which protrude into the intestinal lumen. At the time of her hospitalization due to cholangitis, we started to inform the patient and her family about the risks and benefits of liver transplantation. After five months, she underwent living donor liver transplantation from her father aged 63 years. Three re-laparotomy procedures were needed to correct poor portal blood flow, intestinal perforation, intestinal obstruction, and biliary-enteric anastomotic leakage; she was discharged three months after liver transplantation. Five months after liver transplantation, embolization of the remaining large jejunoileal varices was successfully performed. Two years after liver transplantation, she achieved pregnancy and gave birth to a healthy baby at 38 weeks of gestation with an uneventful course. Adult patients with biliary atresia after surgery, who have chronic liver damage and cirrhosis, have a great risk of deterioration at the time of pregnancy and delivery. Although good pregnancy outcomes after liver transplantation have been reported, the desire of giving birth is an uncommon indication for liver transplantation. The current case highly indicates the need for close monitoring of “child health and development”, meaning that sick children should be cared for until they give birth to and rear the next generation.
