aRenal Division, Department of Medicine and Transplantation Research Center, Brigham and Women's HospitalbRenal Division, Department of Medicine and Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Nephrol Hypertens. 2017 Nov;26(6):494-500. doi: 10.1097/MNH.0000000000000363.
The current article reviews the available literature on the incidence, complications, outcomes, and management of pregnancies in kidney transplant recipients.
Pregnancy can be a reasonable option for women with a kidney transplant. More than 4700 successful pregnancies have been reported after kidney transplantation. New data have emerged regarding the risk of allograft dysfunction following pregnancy. There is a lack of consensus on the optimal time for conception, immunosuppressive targets, the safety of allograft biopsy, and infection surveillance. Successful pregnancies have recently been reported in ABO-incompatible transplant recipients and recipients of combined heart-kidney transplants.
The ideal contraceptive method, timing of conception, immunosuppressant protocol, infection surveillance, and the method of delivery should be individualized depending on the patient's age and medical conditions.
本文回顾了有关肾移植受者妊娠的发生率、并发症、结局和处理的现有文献。
对于肾移植受者，妊娠是一个合理的选择。肾移植后已有超过 4700 例成功妊娠的报道。关于妊娠后移植肾功能障碍的风险，出现了新的数据。对于受孕的最佳时机、免疫抑制目标、移植肾活检的安全性和感染监测，尚无共识。最近在 ABO 不相容移植受者和心脏-肾联合移植受者中也有成功妊娠的报道。
应根据患者的年龄和身体状况个体化选择理想的避孕方法、受孕时机、免疫抑制剂方案、感染监测和分娩方式。
