Department of Medicine, Division of Gastroenterology and Hepatology, University of California, San Francisco, San Francisco, CA, USA.
Department of Renal Medicine, Division of Transplantation and Mucosal Biology, King's College London, London, UK.
Am J Transplant. 2018 May;18(5):1068-1076. doi: 10.1111/ajt.14697. Epub 2018 Mar 30.
Fertility is commonly impaired in women with end-stage kidney and liver disease, although most women will have restoration of fertility within 1 year of transplant. Family planning is therefore critical to discuss with reproductive-aged transplant recipients in the early posttransplant period, in order to ensure timely initiation of contraception, and optimal timing for conception. For women seeking pregnancy, the risks to the mother, graft, and baby should be discussed, including evaluation of immunosuppression safety and potential for adjusting medications prior to conception. With an increasing number of transplant patients now breastfeeding, immunosuppression safety in lactation continues to carry great importance.
患有终末期肾病和肝病的女性通常生育能力受损,尽管大多数女性在移植后 1 年内会恢复生育能力。因此,在移植后早期与育龄期移植受者讨论计划生育至关重要,以确保及时开始避孕,并选择最佳的受孕时机。对于寻求妊娠的女性,应讨论母婴、移植物和婴儿的风险,包括评估免疫抑制安全性和在受孕前调整药物的可能性。随着越来越多的移植患者开始母乳喂养,哺乳期免疫抑制的安全性仍然非常重要。