Costa M L B, Surita F G C, Passini R, Cecatti J G, Boin I F S F
Department of Gynecology and Obstetrics, State University of Campinas, Campinas, Brazil.
Transplant Proc. 2011 May;43(4):1337-9. doi: 10.1016/j.transproceed.2011.02.026.
Transplantation has become an available and successful treatment option for numerous congenital and acquired hepatic disorders. Studies have shown that when the prepregnancy recipient graft function is stable and adequate, pregnancy is normally well tolerated with favorable neonatal outcomes. However, there are reports of increased incidences of hypertension and preeclampsia as well as lower birth weights and prematurity. Patients administered tacrolimus-based therapies seem to have lower incidences of these complications.
The 5 reported patients, aged 23–37 years at the time of conception, were 2–11 years posttransplantation. A preterm delivery for fetal distress was the most clinically important complication among these patients. One episode of acute genital herpes infection, 1 liver hematoma in a patient who was anticoagulated owing to a history of deep vein thrombosis, and 1 case of wound infection postpartum were also observed. Despite these complications, all 5 pregnancies were successful. The mean gestational age at delivery was 35.2 weeks. No structural malformations or early complications were observed in the neonates. All cases showed stable liver parameters.
移植已成为众多先天性和后天性肝脏疾病可行且成功的治疗选择。研究表明，当妊娠前受体移植物功能稳定且足够时，妊娠通常能良好耐受，新生儿结局良好。然而，有报道称高血压和先兆子痫的发病率增加，以及低出生体重和早产情况。接受基于他克莫司治疗的患者这些并发症的发病率似乎较低。
所报告的5例患者在受孕时年龄为23 - 37岁，移植后2 - 11年。因胎儿窘迫早产是这些患者中临床上最重要的并发症。还观察到1例急性生殖器疱疹感染、1例因有深静脉血栓病史而接受抗凝治疗的患者发生肝脏血肿，以及1例产后伤口感染。尽管有这些并发症，但所有5次妊娠均成功。分娩时的平均孕周为35.2周。新生儿未观察到结构畸形或早期并发症。所有病例肝脏参数均稳定。
