National Transplantation Pregnancy Registry: analysis of pregnancy outcomes in female liver transplant recipients.
National Transplantation Pregnancy Registry: analysis of pregnancy outcomes in female liver transplant recipients.
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国家移植妊娠登记处：女性肝移植受者妊娠结局的分析。
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
V. Armenti
中科院分区：
文献类型：
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作者：
J. Radomski;M. Moritz;S. Munoz;Jacqueline Cater;B. Jarrell;V. Armenti
对 34 名女性肝移植受者 48 次妊娠的结果进行了分析。通过访谈、问卷和医院记录收集数据。除 2 名接受 FK506 治疗的患者和 2 名未接受免疫抑制治疗的患者外，所有接受者均接受基于环孢菌素的免疫抑制治疗。受孕年龄为 26.1 +/- 5.9 岁（平均值 +/- SD），移植间隔（从移植到受孕的时间）为 2.9 +/- 2.5 年。有 49 种结果（1 组双胞胎）：流产 9 例（18%）、治疗性流产 4 例（8%）和活产 36 例（74%）。没有死产或宫外孕的报告。 36 例活产婴儿中，胎龄为 36.9 +/- 3.5 周，出生体重为 2,604 +/- 698 克，39% 为早产儿（< 37 周），31% 为低出生体重（< 2,500 克）。没有出生缺陷或新生儿死亡（< 28 天）的报告。新生儿并发症发生率为17%（n = 6），早产儿为5%。药物治疗高血压的发生率为 46%；先兆子痫 21%；感染性并发症 26%；剖腹产占 47%。高血压患者的早产儿比例 (71%) 高于血压正常患者 (38%)（费希尔精确检验 P = 0.04）。 6 次妊娠被诊断为急性排斥反应，其中 2 次通过治疗性流产结束。四名继续妊娠的受孕者接受了针对排斥反应的增强免疫抑制治疗，并且全部顺利分娩。怀孕 6 个月内失去了两个移植物。唯一的孕产妇死亡发生在一名患者，她在治疗性流产后 3 个月因复发性丙型肝炎需要再次移植，并于 6 个月后死亡。另一名移植物丢失的受者在分娩后 6 个月因慢性排斥反应成功再次移植。我们得出以下结论：（1）女性肝移植受者可以安全妊娠，但早产儿和低体重儿发生率较高； (2)该人群妊娠应视为高危人群，需要密切监测肝功能； (3) 应彻底调查妊娠期间移植物功能的变化。
Outcomes from 48 pregnancies in 34 female liver transplant recipients were analyzed. Data were collected via interviews, questionnaires, and hospital records. All recipients were treated with cyclosporine-based immunosuppression except 2 patients treated with FK506 and 2 treated with no immunosuppression. The age at conception was 26.1 +/- 5.9 years (mean +/- SD) with a transplant interval (time from transplantation to conception) of 2.9 +/- 2.5 years. There were 49 outcomes (1 set of twins): miscarriage 9 (18%), therapeutic abortion 4 (8%), and live birth 36 (74%). No stillbirths or ectopic pregnancies were reported. Of the 36 live births, the gestational age was 36.9 +/- 3.5 weeks, the birthweight was 2,604 +/- 698 grams, 39% were premature (< 37 weeks), and 31% had low birthweight (< 2,500 grams). No birth defects or neonatal deaths (< 28 days) were reported. The newborn complication rate was 17% (n = 6), 5% in premature infants. The incidence of drug-treated hypertension was 46%; pre-eclampsia 21%; infectious complications 26%; and Caesarean section 47%. Recipients with hypertension had a higher proportion of premature infants (71%) than normotensive patients (38%) (P = .04 by Fisher's exact test). Acute rejection was diagnosed in 6 pregnancies, 2 of which were ended by therapeutic abortion. Four recipients who continued their pregnancies were treated with increased immunosuppression for rejection, and all delivered livebirths. There were two grafts lost within 6 months of pregnancy. The only maternal death occurred in a patient who required retransplantation for recurrent C hepatitis 3 months afte therapeutic abortion and died 6 months later. The other recipient with graft loss was successfully retransplanted for chronic rejection 6 months after delivery. We draw the following conclusions: (1) female liver transplant recipients can safely undergo pregnancy, although there is a high rate of premature and low birthweight infants; (2) pregnancies in this population should be considered high-risk and require close monitoring of liver function; and (3) altered graft function during pregnancy should be thoroughly investigated.
FK506 与肝移植患者妊娠。
影响因子：
6.2
作者：
Jain,A;Venkataramanan,R;Lever,J;Warty,V;Fung,J;Todo,S;Starzl,T
通讯作者：
Starzl,T
影响因子：
6.2
作者：
Scantlebury,V;Gordon,R;Tzakis,A;Koneru,B;Bowman,J;Mazzaferro,V;Stevenson,WC;Todo,S;Iwatsuki,S;Starzl,TE
通讯作者：
Starzl,TE