Introduction : There were many studies showed the successful pregnancy and delivery in patients after liver transplantation. From 2012 more than 100 living donor liver transplantations has carried out in Kazakhstan and our report represents the first successful pregnancy and delivery in recipient after liver transplantation.

Methods : Orthotopic transplantation of right liver lobe from a living related donor was performed to our patient from her elder brother. The main cause of liver cirrhosis was autoimmune hepatitis. After one year of LDLT the patient informed us about unplanned pregnancy.

Results : Among complications in early postoperative period the portal vein thrombosis was detected and successfully treated by heparin monotherapy. No other complications found in late period after transplantation. The standard third-component immunosuppressive therapy (CNI + MMF + GCS) was applied during the first year after transplantation. After the sudden information of 2 weeks pregnancy the MMF application was canceled. In first three months no significant alterations were found during the childbearing. On 18-20 weeks the first signs of liver rejection was appeared where sensitization of HLA class 1 was 0% and HLA class 2 consisted 91%. As a main treatment the pulse therapy with GCS and plasmapheresis were performed. On 40 weeks delivery was successfully done by Cesarean section. The child was male with weight - 2830 g, and height - 54.3 cm and without no visible any defects.

Conclusions : In our case, it was an acceptable outcome for both mother and baby, although considered a high risk pregnancy.