女性肾移植受者的妊娠与生育问题  

Pregnancy and fertility in female kidney transplant recipients

作　　者：许龙根[1] 

机构地区：[1]中国人民解放军第117医院肾移植中心,杭州310013

出　　处：《中华移植杂志（电子版）》2015年第1期6-12,共7页Chinese Journal of Transplantation(Electronic Edition)

基　　金：浙江省科技科研基金项目(2010C33804);杭州市科技科研基金项目(20090833B22);浙江省医药卫生科研项目(2009A182);南京军区医药卫生科研项目(2008MA122)

摘　　要：器官移植受者是一特殊群体,对大多数育龄青年来说,他们渴望拥有一个幸福家庭的同时能生育一个健康的孩子。1963年,Murray等学者首次报道了肾移植术后成功生育的病例。1991年,美国成立了国家移植妊娠登记处(NTPR)。2012年,NTPR获得了临床试验评审及管理委员会批准,获准收集术后受孕时服用免疫抑制剂的女性受者信息。迄今为止,全球大约有17 000名移植受者所生子女。然而有关中国大陆肾移植受者术后妊娠与生育,还仅有为数不多的报道。目前,中国大陆还没有建立器官移植妊娠与生育的登记组织机构,仍然根据为数不多的临床资料来指导器官移植受者妊娠与生育,对其认识非常有限。因此,对女性肾移植受者术后妊娠、分娩应慎重,需要进行全面评估。整个妊娠、分娩过程应有移植科、产科以及心内科等医师共同参与指导和监测,以确保子女、移植肾以及受者自身的安全,减少胎儿与新生儿异常以及移植器官失功的发生。Organ transplant recipients are a special group. As most young people of childbearing age, they are eager to have a happy family and be able to grant pregnant, birth of a heahhy child. In 1963, Murray first reported a case of successful fertility after kidney transplantation. In 1991, the National Transplantation Pregnancy Registry （NTPR） was established in the United States. In 2012, Clinical Trial Assessment and Management Committees approved NTPR in gathering information on the female recipients taking immunosuppressants after conception. To date, there are about 17 000 children were born by transplant recipients. However, there are few reports on post-kidney-transplant recipients about their pregnancy and fertility in China's Mainland. At present, China has not established an organ transplantation pregnancy and birth registration organization; while clinical doctors have to guide organ transplant recipients＇ pregnancy and childbirth based on a small number of clinical data. Awareness on organ transplant recipients pregnancy and fertility is very limited. Therefore, cautious treatment and overall evaluation need to be given to those female post-kidney-transplant recipients while being pregnant and delivering. The whole process of pregnancy and delivering should be participated by doctors from transplantation, obstetrical and cardiovascular department to help instructing and monitoring. This could help to make sure the safety of babies, transplanted kidneys and the recipients. It would also reduce the incidence of newborn abnormality and dysfunction of transplanted kidneys.

关 键 词：肾移植 妊娠特点 生育条件 免疫抑制剂 

分 类 号：R699.2[医药卫生—泌尿科学]