肾移植术后妊娠五例六次  

Pregnancy after renal transplantation： 5 cases report

作　　者：金石华[1] 李响[2] 田野[3] 张愚[2] 韩志友[2] 张志宏[1] 那彦群[1] 

机构地区：[1]北京大学首钢医院北京大学吴阶平泌尿外科医学中心,100144 [2]北京中医药大学东直门医院泌尿外科 [3]首都医科大学附属北京友谊医院泌尿外科

出　　处：《中华器官移植杂志》2013年第3期171-173,共3页Chinese Journal of Organ Transplantation

摘　　要：目的探讨肾移植术后妊娠对受者及移植肾的影响。方法回顾性分析5例6次肾移植术后妊娠的临床资料。结果受者妊娠时平均年龄为31．1岁，移植至妊娠的时间平均为3．6g。5例6次妊娠中发生先兆子痫2例次，高脂血症1例次。最终成功分娩4例，分别于38周、35周、35周和38周接受剖宫产，新生儿平均体重为3262．5g，新生儿Apgar评分均为10分。2例次因减少或停用免疫抑制剂，移植肾功能丧失而终止妊娠，其中1例接受再次肾移植后再次妊娠并成功分娩。结论对于移植肾功能正常的女性受者，在合理应用免疫抑制剂的前提下妊娠和分娩是可行的，但具有较高风险，需要严密监护。Objective To evaluate the effect of pregnancy ＂and delivery after renal transplantation （RT）on recipients, graft and offspring. Methods Clinical data of 6 pregnancies in 5 recipients were retrospectively studied and literature was reviewed. Results Among them, 6 pregnancies and 4 deliveries occurred in 5 female RT recipients. The mean age at pregnancy was 31.1 years, with a mean interval between RT and pregnancy being 3.6 years. Preeclampsia developed in two pregnancies and hyperlipemia in one pregnancy. One RT recipient who discontinued immunosuppressant following pregnancy on her own exhibited subsequent renal failure. She underwent a second RT and delivered a healthy baby two years following the second RT. One RT recipient decreased the immunosuppressant dose to half after the pregnancy on her own and developed renal failure thereafter. Four patients underwent a Cesarean section at 38 th,35 th,35 th, and 38 th week, respectively. The mean birth weight was 3262. 5 g with all Apgar scores of 10. Conclusion Our data coupled with prior reports suggest that for the recipients with normal renal function, successful pregnancy is achievable if immunosuppressant was taken correctly, but the pregnancy is at high risk, and careful monitoring is needed.

关 键 词：肾移植 妊娠 

分 类 号：R699.2[医药卫生—泌尿科学]