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妊娠对肾移植结局的影响。

Impact of pregnancy on the outcome of kidney transplantation.

作者信息

Kashanizadeh N, Nemati E, Sharifi-Bonab M, Moghani-Lankarani M, Ghazizadeh S, Einollahi B, Lessan-Pezeshki M, Khedmat H

机构信息

Nephrology and Urology Research Center (NURC), Baqiyatallah Medical Sciences University, Tehran, Iran.

出版信息

Transplant Proc. 2007 May;39(4):1136-8. doi: 10.1016/j.transproceed.2007.03.010.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

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