Prodromidou A, Kostakis I D, Machairas N, Garoufalia Z, Stamopoulos P, Paspala A, Sotiropoulos G C
Second Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Second Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Transplant Proc. 2019 Mar;51(2):446-449. doi: 10.1016/j.transproceed.2019.01.014. Epub 2019 Jan 4.
Liver transplantation (LT) constitutes a major therapeutic option for a number of patients suffering from liver pathologies. Pregnancy outcomes in patients who have undergone LT are assessed by a number of studies. The aim of our systematic review was to present the currently available evidence concerning the results of pregnancy in patients with LT.
A meticulous systematic search of the literature published before September 2017 for studies relevant in this field was conducted. All studies, which presented obstetric and maternal outcomes of patients with prior LT, were included.
Nineteen studies, which comprised 1290 pregnancies in 885 female LT recipients, were reviewed. A total of 1014 live births were recorded, and the incidence of spontaneous abortions ranged from 0.5% to 33.3%. Concerning live births, a proportion of 32% of pregnancies resulted in preterm births (345 preterm births in 1079 pregnancies, range 0%-39%), and in 16% of pregnancies preeclampsia was reported (188 cases from 1173 pregnancies, range 2%-33.3%). The most commonly administered immunosuppressive drugs were cyclosporine and tacrolimus alone or with steroids. Cesarean section rates ranged from 20% to 67.9% among the included studies, concerning live birth. Moreover, approximately one-third of them resulted in preterm birth. Spontaneous abortions were reported in 176 cases (range: 0.5%-33.3%), and preeclampsia occurred in 188 patients (range: 2%-33.3%).
Pregnancy outcomes from the included studies are encouraging, nonetheless pregnant patients who have undergone LT are at high risk and therefore require close monitoring by a multidisciplinary team.
肝移植（LT）是许多患有肝脏疾病患者的主要治疗选择。多项研究评估了接受LT患者的妊娠结局。我们系统评价的目的是呈现目前关于LT患者妊娠结果的现有证据。
对2017年9月之前发表的该领域相关文献进行了细致的系统检索。纳入了所有呈现既往LT患者产科和母体结局的研究。
对19项研究进行了综述，这些研究包括885名女性LT受者的1290次妊娠。共记录到1014例活产，自然流产发生率在0.5%至33.3%之间。关于活产，32%的妊娠导致早产（1079例妊娠中有345例早产，范围为0%-39%），16%的妊娠报告有子痫前期（1173例妊娠中有188例，范围为2%-33.3%）。最常用的免疫抑制药物是单独使用的环孢素和他克莫司，或与类固醇联合使用。在所纳入的关于活产的研究中，剖宫产率在20%至67.9%之间。此外，其中约三分之一导致早产。报告自然流产176例（范围：0.5%-33.3%），子痫前期发生在188例患者中（范围：2%-33.3%）。
纳入研究的妊娠结局令人鼓舞，尽管如此，接受LT的妊娠患者仍处于高风险中，因此需要多学科团队进行密切监测。
