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[肾移植后的妊娠——临床问题与遗传学研究]

[Pregnancies following kidney transplantation--clinical problems and genetic studies].

作者信息

Koall W, Müller R

机构信息

Nephrologischen Abteilung, Martin-Luther-Universität Halle-Wittenberg.

出版信息

Z Gesamte Inn Med. 1988 Sep 1;43(17):479-84.

PMID:3070974
Abstract

Successful transplantations of the kidney by means of the medical rehabilitation also improve the reproductive rehabilitation of the young patients with distinct wish for children. In these cases the increased infectious, genetic, rejection and tumour risks as well as a limited transplant survival time require particular consideration. On 15 pregnancies among 151 patients in the Regional Dispensary for Patients who underwent kidney transplantations in Halle the clinical and genetic problems are discussed. A patient with preexisting risk factors under interdisciplinary intensive care bore a healthy child who is now 10 years old. The mother is still alive 12 years after the transplantation. Studies on 6 pregnancies in 3 patients who underwent a transplantation revealed 1 normal delivery and 5 interruptions for somatic and genetic indications. 2 female patients are alive 5 and 12 years after transplantation, 1 female patient again undergoes dialysis. From 9 pregnancies by 8 fathers who underwent transplantation 8 children were born (4-10 years) and 1 interruption had to be made. 4 patients live in the 8th to 11th year with the first transplant and 1 patient lives with the second transplant for 8 years. 4 patients again underwent dialysis, one patient died. Human-genetic problems are existing in the autosomal-recessively hereditary Alport-syndrome by the daughter as gene-carrier. 15 analyses of chromosomes on 396 investigated mitoses resulted in chromosomal break rates of 2, 4.7 and 5% in three children at the end of the second year of age, in the mother of 7% in the 4th year and in 2 fathers of 4 and 22% in the 4th and 5th year after transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

通过医学康复手段成功进行肾脏移植,也改善了有强烈生育意愿的年轻患者的生殖康复情况。在这些案例中,感染、遗传、排斥和肿瘤风险增加以及移植存活时间有限等问题需要特别考虑。本文讨论了哈雷地区肾脏移植患者区域诊疗所151例患者中的15例妊娠的临床和遗传问题。一名存在既往风险因素的患者在跨学科重症监护下诞下一名健康儿童,该儿童现已10岁。母亲在移植后12年仍然健在。对3例接受移植的患者的6次妊娠研究显示,1例正常分娩,5例因躯体和遗传指征而终止妊娠。2名女性患者在移植后5年和12年仍然存活,1名女性患者再次接受透析治疗。8名接受移植的父亲的9次妊娠中,8名儿童出生(4至10岁),1例妊娠终止。4例患者在首次移植后的第8至11年存活,1例患者在第二次移植后存活8年。4例患者再次接受透析治疗,1例患者死亡。女儿作为基因携带者患有常染色体隐性遗传性奥尔波特综合征,存在人类遗传问题。对396个研究的有丝分裂进行的15次染色体分析显示,3名儿童在2岁末的染色体断裂率为2%、4.7%和5%,母亲在第4年为7%,2名父亲在移植后第4年和第5年分别为4%和22%。(摘要截选于250词)

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