Klein Christina L, Josephson Michelle A
Piedmont Transplant Institute, Piedmont Healthcare Inc., Atlanta, Georgia.
Section of Nephrology, Division of Biological Sciences, University of Chicago, Chicago, Illinois.
Clin J Am Soc Nephrol. 2022 Jan;17(1):114-120. doi: 10.2215/CJN.14100820. Epub 2021 Mar 17.
Placed in a historical context, this overview focuses on post-transpant pregnancy, fatherhood, and contraception in women and men. The critical importance of early reproductive counseling because of improved sexual function and the early return of ovulation and menses post-transplant is emphasized. We explain the decision making regarding contraception choices. The available data on the safety of immunosuppressive drugs in pregnancy, and for men desiring fatherhood, are detailed. The risk of maternal ingestion of mycophenolate products on the fetus is considered and contrasted with the lack of concern for their use by men fathering children. Pregnancy risks to the allograft, baby, and mother are discussed. An infant's exposure to specific immunosuppressant medications through breastfeeding is reviewed. The ethics and realities of post-transplant parenthood are explored.
置于历史背景下，本综述聚焦于移植后妊娠、为人父以及男女避孕问题。强调了早期生殖咨询的至关重要性，因为移植后性功能改善以及排卵和月经较早恢复。我们解释了避孕选择的决策过程。详细介绍了妊娠期间免疫抑制药物安全性以及男性生育方面的现有数据。考虑了母亲摄入霉酚酸酯产品对胎儿的风险，并与男性生育时使用此类药物无需担忧的情况进行了对比。讨论了对移植器官、婴儿和母亲的妊娠风险。回顾了婴儿通过母乳喂养接触特定免疫抑制药物的情况。探讨了移植后为人父母的伦理和现实问题。
