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妊娠期间肾移植后使用依维莫司:病例报告和系统评价。

Use of everolimus following kidney transplantation during pregnancy: A case report and systematic review.

机构信息

Department of Pharmacy, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan.

Department of Pediatrics, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2023 Sep;62(5):774-778. doi: 10.1016/j.tjog.2023.07.026.

Abstract

OBJECTIVE

There is limited safety data on the use of everolimus during pregnancy. In this study, we present the maternal and neonatal outcomes of everolimus used throughout the course of pregnancy and conducted a systematic review of reports of everolimus use after organ transplantation during pregnancy.

CASE REPORT

A woman with type 1 diabetes who underwent kidney transplantation was treated with tacrolimus, everolimus, and prednisolone. Two years later, she became pregnant. At 27 weeks of gestation, an emergent cesarean delivery was performed owing to severe preeclampsia and fetal distress. No congenital malformation was noted in the baby at a corrected age of 4 months, and the maternal renal function remained stable.

CONCLUSION

Our systematic review did not identify evidence of teratogenicity in babies exposed to everolimus as an immunosuppressant after transplantation. To better assess the risk of exposure to everolimus during pregnancy, all cases of new pregnancies occurring in transplant recipients receiving treatment with mammalian target of rapamycin inhibitor inhibitors should be reported.

摘要

目的

在怀孕期间使用依维莫司的安全性数据有限。本研究报告了在整个孕期使用依维莫司的母婴结局,并对器官移植后怀孕期间使用依维莫司的报告进行了系统回顾。

病例报告

一名患有 1 型糖尿病的女性接受了肾移植,接受了他克莫司、依维莫司和泼尼松龙治疗。两年后,她怀孕了。在 27 周妊娠时,由于严重的子痫前期和胎儿窘迫,进行了紧急剖宫产。在纠正年龄为 4 个月时,婴儿未发现先天性畸形,母体肾功能保持稳定。

结论

我们的系统回顾未发现在移植后作为免疫抑制剂暴露于依维莫司的婴儿有致畸性的证据。为了更好地评估在怀孕期间接触依维莫司的风险,应报告所有接受雷帕霉素靶蛋白抑制剂治疗的移植受者发生的新妊娠病例。

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