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肝移植受者妊娠结局:土耳其单中心经验。

Outcomes of Pregnancies in Liver Transplant Recipients: Experience of a Single Center in Turkey.

机构信息

Department of Midwifery, Faculty of Health Sciences, Uskudar University, Istanbul, Turkey.

Department of Obstetrics and Gynecology, Memorial Atasehir Hospital, Istanbul, Turkey.

出版信息

Arch Iran Med. 2022 Dec 1;25(12):828-834. doi: 10.34172/aim.2022.128.

Abstract

BACKGROUND

Liver transplantation is the ultimate treatment for end-stage liver failure. As organ donation systems improve, more reproductive-age women are expected to undergo liver transplantation. Current studies indicate increased risk of some perinatal and maternal complications; however, the available data is still scarce. Therefore, we aimed to evaluate the maternal and fetal outcomes of pregnancies in liver transplant recipients.

METHODS

We retrospectively evaluated liver transplantations performed between 2011 and 2020 in a tertiary center. Perinatal, maternal, fetal outcomes and transplant status were assessed among pregnancies conceived after liver transplantation.

RESULTS

Among 1137 patients, 82 (7.2%) were reproductive-age females. Ten pregnancies in nine patients were identified after liver transplantation. The mean age of patients was 29.3±6.1 at transplantation, and 32.5±5.4 at conception. The mean interval between conception and transplantation was 30.3±11.7 months. There were eight live births (80%), one miscarriage (10%) and one termination (10%). Three patients delivered<37 gestational week (37.5%). The median gestational age at birth was 38.5 (IQR: 5.21) weeks. The mean birth weight of infants was 2669.3±831 g. Two patients were diagnosed with preeclampsia (25%) and acute graft rejection episode was observed in one patient (10%) during pregnancy.

CONCLUSION

Although the incidence of some perinatal complications, such as hypertensive disorders and preterm delivery, is increased in liver transplant recipients, pregnancy after liver transplantation appears to have favorable outcomes for the mother, fetus and transplant with close monitoring by a multidisciplinary team.

摘要

背景

肝移植是治疗终末期肝功能衰竭的终极手段。随着器官捐献系统的完善,越来越多的育龄妇女将接受肝移植。目前的研究表明,肝移植受者妊娠存在一些围产期和母体并发症风险增加;然而,可用数据仍然有限。因此,我们旨在评估肝移植受者妊娠的母婴结局。

方法

我们回顾性评估了 2011 年至 2020 年在一家三级中心进行的肝移植。评估了肝移植后受孕的妊娠的围产期、母体、胎儿结局和移植状况。

结果

在 1137 例患者中,有 82 例(7.2%)为育龄女性。9 例患者的 10 例妊娠在肝移植后被发现。患者的平均年龄在移植时为 29.3±6.1 岁,受孕时为 32.5±5.4 岁。受孕与移植之间的平均间隔为 30.3±11.7 个月。有 8 例活产(80%),1 例流产(10%)和 1 例终止妊娠(10%)。3 例患者分娩<37 孕周(37.5%)。出生时的中位胎龄为 38.5(IQR:5.21)周。婴儿的平均出生体重为 2669.3±831 克。2 例患者被诊断为子痫前期(25%),1 例患者在妊娠期间出现急性移植物排斥反应(10%)。

结论

尽管肝移植受者的一些围产期并发症(如高血压疾病和早产)的发生率增加,但肝移植后妊娠似乎对母亲、胎儿和移植有良好的结局,通过多学科团队的密切监测即可。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f44/10685838/314e9456b818/aim-25-828-g001.jpg

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