Goarin A-C, Homer L
Service de gynécologie obstétrique et médecine de la reproduction, hôpital Morvan, CHU de Brest, 2, avenue Foch, 29609 Brest, France.
J Gynecol Obstet Biol Reprod (Paris). 2010 Nov;39(7):529-36. doi: 10.1016/j.jgyn.2010.01.001. Epub 2010 Feb 7.
Management during their sexual life of patients with a liver transplantation is a more or less common situation depending centers. Based on literature review, a focus on management of recipient women was conducted, from contraception to pregnancy, describing the complications related to the status of transplant recipient, but also those that may be related to immunosuppressive agents. If fertility and access to contraception are only slightly modified by graft, complications related to graft or immunosuppressive drugs can affect the pregnancy. On the maternal side, hypertension and preeclampsia are more common, as well as renal dysfunction, iatrogenic diabetes and bacterial or viral infections, acute rejection and graft loss do not appear to be influenced by pregnancy. The fetus is also exposed to risks such as induced prematurity and IUGR. Pregnancy in recipients of hepatic grafts therefore requires joint follow-up by transplant specialist and perinatologist, which leads in most cases to successful outcome for mother and child.
肝移植患者性生活期间的管理情况因中心而异，或多或少较为常见。基于文献综述，重点关注了受者女性从避孕到怀孕的管理，描述了与移植受者状态相关的并发症，以及可能与免疫抑制剂有关的并发症。虽然移植对生育能力和避孕措施的影响较小，但与移植或免疫抑制药物相关的并发症可能会影响妊娠。在母亲方面，高血压和先兆子痫更为常见，肾功能不全、医源性糖尿病以及细菌或病毒感染也较为常见，急性排斥反应和移植物丢失似乎不受妊娠影响。胎儿也面临诸如早产和宫内生长受限等风险。因此，肝移植受者的妊娠需要移植专科医生和围产医学专家的联合随访，在大多数情况下，这会使母婴获得成功结局。
