Peer-reviewed article

Health outcomes of children born to liver transplant recipients.

Sarah L Maxwell, Lisa A Coscia, Serban Constantinescu, Michael J Moritz, Carol L Wilkinson et al. · 3 Sept 2026

Abstract

Leveraging the Transplant Pregnancy Registry International, we conducted a retrospective study of children born to liver transplant (LT) recipients between 1986 and 2024 to evaluate long-term health outcomes of offspring. Child data were collected primarily from biyearly maternal phone interviews. Descriptive statistics and multivariate analyses were used to evaluate risk factors for adverse child outcomes. There were 599 children with follow-up data, born to 435 LT recipients, of whom 73.3% were White and 13.1% Hispanic, with a median age at conception of 29.4 years. The most common LT indications were autoimmune hepatitis (14.2%) and biliary atresia (13.9%); the median time from LT to delivery was 6.9 (interquartile range, 3.1-14.2) years; 21.0% of mothers required antihypertensive medications during their pregnancy, 20.7% developed preeclampsia, and 46.1% had cesarean delivery. Most (68.3%) children were healthy and developing well at a median follow-up time of 7.6 (interquartile range, 3.4-14.9) years. The most common pediatric conditions in offspring were allergies (6.5%), asthma/reactive airway disease (4.7%), attention deficit hyperactivity disorder/attention deficit disorder (4.7%), mild developmental delay (2.7%), autism spectrum disorder (2.0%), and mood disorders (1.2%). Most school-age children of LT recipients were healthy overall, without greater risk for growth or cognitive conditions than the general pediatric population.