Department of Clinical Sciences, University of Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Norway.
Am J Transplant. 2015 Jun;15(6):1666-73. doi: 10.1111/ajt.13159. Epub 2015 Apr 13.
Immunosuppressive drugs may influence spermatogenesis, but little is known about outcome of pregnancies fathered by transplanted males. We estimated risk of adverse outcomes in pregnancies (with data after the first trimester) fathered by males that had undergone organ transplantation and were treated with immunosuppression. A population-based study, linking data from the Norwegian transplant registry and the Medical Birth Registry of Norway during 1967-2009 was designed. All Norwegian men undergoing solid organ transplantation were included. Odds ratios for major malformations, preeclampsia, preterm delivery (<37 weeks) and small-for-gestational-age were obtained using logistic regression. A total of 2463 transplanted males, fathering babies of 4614 deliveries before and 474 deliveries after transplantation were identified. The risk of preeclampsia was increased (AOR: 7.4, 95% CI: 1.1-51.4,) after transplantation compared to prior to transplantation. No increased risk was found for congenital malformations or other outcomes when compared with pregnancies before transplantation or with the general population (2 511 506 births). Our results indicate an increased risk of preeclampsia mediated through the transplanted and immunosuppressed father. Importantly, no increased risk was found for other adverse obstetric outcomes or malformations, which may reassure male transplant recipients planning to father children.
免疫抑制药物可能会影响精子发生，但对于接受过器官移植并接受免疫抑制治疗的男性所生育的妊娠结局知之甚少。我们评估了经历过器官移植和接受免疫抑制治疗的男性所生育的妊娠（有孕 13 周后数据）出现不良结局的风险。我们设计了一项基于人群的研究，将 1967 年至 2009 年期间来自挪威移植登记处和挪威医学出生登记处的数据进行了关联。所有接受实体器官移植的挪威男性都包括在内。使用逻辑回归获得了主要畸形、子痫前期、早产（<37 周）和小于胎龄儿的比值比。共确定了 2463 名接受过器官移植的男性，他们生育了 4614 次妊娠前和 474 次妊娠后的婴儿。与移植前相比，移植后子痫前期的风险增加（OR：7.4，95%CI：1.1-51.4）。与移植前妊娠或与一般人群（2 511 506 次妊娠）相比，先天性畸形或其他结局的风险没有增加。我们的结果表明，移植和免疫抑制的父亲会增加子痫前期的风险。重要的是，对于其他不良产科结局或畸形，没有发现风险增加，这可能会让计划生育孩子的男性移植受者感到安心。
