A team of doctors at Global Hospital, Parel, Mumbai, successfully helped a 24-year-old liver transplant recipient Mehjaben Atif Kolad, deliver a baby boy weighing 2.9 kgs on May 4. The patient underwent liver transplantation in 2014, due to acute liver failure, when she was 18-years-old. She conceived last year, and both the mother and baby are fine now.
Patient Mehjaben Atif Kolad, a resident of Mumbai, suffered from tuberculosis (TB) in 2013. The TB medicines took a toll on her liver and she landed with jaundice at Global Hospital in 2014. The investigations revealed that there were acute liver and kidney failure. To her family’s dismay, she slipped into a coma and was on the ventilator. Since her condition was critical the doctors decided to do liver transplantation as her INR was very high and on the basis of her blood tests. She was fortunate that she did not have to wait long for finding a suitable donor for a liver transplant as the patient’s mother was found to be fit and she donated a part of her liver.
Dr. Akash Shukla, Transplant Hepatologist at Global Hospital, Parel, Mumbai, said, “She was under close follow-up, post liver transplant. Her condition improved and she got rid of TB as well. The patient, who never missed her follow-ups, resumed her day-to-day activities within a few months after the transplant.”
Two years ago, Mehjaben, got married to the love of her life who was her backbone during her difficult times and the next landmark to be crossed was pregnancy. After liver transplantation, ideally, a woman should wait for a year, before attempting pregnancy as the physiological function of reproduction assumes by 10 months. The patient was apprehensive about pregnancy as she had undergone a transplant and she weighed only 36 kgs. However, with constant reassurances from the doctors and family, she conceived nine months ago, in 2018. During pregnancy, she meticulously followed-up with the doctors and was on maintained on a minimum dose of the single immunosuppressant drug – tacrolimus. She was advised to stick to her daily diet and take a protein supplement. The baby’s growth was monitored very closely and was healthy throughout her antenatal period.
Dr. Anagha Chhatrapati, Gynecologist at Global Hospital, Parel, Mumbai, said, “The patient registered at our hospital at 6 weeks of gestation. Since she was a recipient of liver transplantation, she was immediately categorized for extremely high-risk pregnancy. Her pregnancy was tricky as the patients with hepatic transplantation are at high risk for abortion, high blood pressure, preterm labor, low birth weight, and most dreaded graft rejection.”
“With a multidisciplinary approach, we strictly monitored her maternal and fetal growth. At full term, the decision was taken to give her trial of labor, as there was no contraindication for normal delivery. At 37 weeks she went into spontaneous labor, the baby’s heartbeats were continuously monitored. I feel that every mother deserves a fair trial of normal delivery, so we did with this patient. On May 4th, she gave birth to a baby boy weighing 2.9 kgs via normal delivery. Both mother and baby are healthy, and were discharged on the third day of delivery,” added Dr. Anagha.
Patient Mehjaben Atif Kolad said, “I am happy that I was able to conceive even after undergoing liver transplantation. I thank my family and the doctors from the Global Hospital for their constant support. Doctors at Global Hospital encouraged and supported me post liver transplant surgery. It is because of them and my family that I could fulfill my dream of becoming a mother. Moreover, it becomes even more special as I delivered a baby in the holy month of Ramadan and mother’s day. I want to wish all the mothers a happy mother’s day and I am grateful to my mother for giving me a new lease of life.”
What is the right time to conceive after a liver transplant?
· After liver transplantation, ideally a woman should wait for 1 year, before attempting pregnancy. The physiological function of reproduction resumes by 10 months post-transplant.
· High dose immunosuppressive therapy can adversely affect the growing foetus, in the form of abortion, stunted growth, congenital anomalies in baby and preterm labor.
· Pregnancy is safest when the woman is on very low dose immunosuppressive therapy.