Kashanizadeh N, Nemati E, Sharifi-Bonab M, Moghani-Lankarani M, Ghazizadeh S, Einollahi B, Lessan-Pezeshki M, Khedmat H
Nephrology and Urology Research Center (NURC), Baqiyatallah Medical Sciences University, Tehran, Iran.
Transplant Proc. 2007 May;39(4):1136-8. doi: 10.1016/j.transproceed.2007.03.010.
There is still controversy over whether pregnancy adversely affects renal transplantation outcomes. We, thus, compared two groups of kidney transplant recipients in terms of patient survival and allograft function: those who did versus did not conceive posttransplant.
This historical cohort study conducted between 1996 and 2002, divided female kidney transplant recipients of reproductive age into group I (n=86, at least one posttransplant pregnancy) and group II (n=125, no posttransplant pregnancy). The two groups were matched for age, cause of end-stage renal disease (ESRD), treatment protocol, and first creatinine (Cr). All patients received a first transplant and all had a Cr less than 1.5 mg/dL on entry into the study. The subjects were followed for 45.4 +/- 22.0 and 46.3 +/- 19.8 months, respectively (P>.05). Five-year patient and graft survivals and Cr were considered to be the main outcome measures.
Mean (SD) age in groups I and II was 26.6 +/- 6.6 and 26.9 +/- 8.1 years, respectively (P>.05). Five-year patient and graft survival rates were not significantly different between the study groups. Of the women in group 1, only 9 (10.5%) subjects displayed elevated serum Cr levels (>1.5 mg/dL) at the end of follow-up, while the serum Cr levels in 35 (28%) group II patients were above 1.5 mg/dL (P=.024).
Our results indicates pregnancy did not seem to adversely affect patient and graft survival among kidney transplant recipients. Renal transplantation in stable women of childbearing age should not be a contraindication to pregnancy.
妊娠是否会对肾移植结果产生不利影响仍存在争议。因此,我们比较了两组肾移植受者的患者生存率和移植肾功能:移植后怀孕的患者与未怀孕的患者。
这项历史性队列研究于1996年至2002年进行,将育龄期女性肾移植受者分为I组(n = 86,至少有一次移植后妊娠)和II组(n = 125,无移植后妊娠)。两组在年龄、终末期肾病(ESRD)病因、治疗方案和首次肌酐(Cr)水平方面进行了匹配。所有患者均接受了首次移植,且在进入研究时肌酐水平均低于1.5mg/dL。分别对受试者进行了45.4±22.0个月和46.3±19.8个月的随访(P>0.05)。将五年患者和移植物生存率以及肌酐水平视为主要结局指标。
I组和II组的平均(标准差)年龄分别为26.6±6.6岁和26.9±8.1岁(P>0.05)。研究组之间的五年患者和移植物生存率无显著差异。在I组女性中,只有9名(10.5%)受试者在随访结束时血清肌酐水平升高(>1.5mg/dL),而II组35名(28%)患者的血清肌酐水平高于1.5mg/dL(P = 0.024)。
我们的结果表明,妊娠似乎不会对肾移植受者的患者和移植物生存率产生不利影响。稳定的育龄期女性进行肾移植不应成为妊娠的禁忌证。