肝移植術后妊娠_《中國普外基礎與臨床雜志》

作者：

陳真 ¹ , 文天夫 ²

1.重慶市婦幼保健院產科(重慶400013）;;
2.四川大學華西醫院普外二科（成都610041）;

關鍵詞：

肝移植妊娠指征并發癥

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的探討肝移植術后妊娠的指征，母體和胎兒/新生兒存在的風險及其處理措施。
方法復習相關文獻并進行綜述。
結果肝移植術后多數育齡婦女可以恢復正常月經周期。高血壓、腎功能損害、先兆子癇、繼發于免疫抑制的細菌和病毒感染以及剖宮產幾率增加是母體的主要風險。胎兒/新生兒的風險主要是流產、早產、胎膜早破、腎上腺皮質功能不足、胎兒畸形、免疫缺陷和巨細胞病毒、乙肝病毒及細菌感染。
結論在多數患者，肝移植術后妊娠可以獲得良好效果，但在妊娠前應進行嚴格的評估，在妊娠期應多科聯合進行嚴密的監測。當前應制定一個基于現有研究結果的肝移植術后妊娠指南。

引用本文： 陳真,文天夫. 肝移植術后妊娠. 中國普外基礎與臨床雜志, 2006, 13(4): 487-489下轉492. doi: 復制

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4.	Braun N, Dette S, Viebahn R. Impairment of renal function following liver transplantation [J]. Transplant Proc， 2003; 35(4)∶1458.
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6.	Armenti VT, Herrine SK, Radomski JS, et al. Pregnancy after liver transplantation [J]. Liver Transpl， 2000; 6(6)∶671.
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10.	Pruvot FR, Declerck N, ValatRigot AS, et al. Pregnancy after liver transplantation: focusing on risks to the mother [J]. Transplant Proc， 1997; 29(5)∶2470.
11.	Armenti VT, Herrine SK, Moritz MJ. Reproductive function after liver transplantation [J]. Clin Liver Dis， 1997; 1(2)∶471.
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13.	Jain AB, Reyes J, Marcos A, et al. Pregnancy after liver transplantation with tacrolimus immunosuppression: a single center’s experience update at 13 years [J]. Transplantation， 2003; 76(5)∶827.
14.	Florman S, Schiano T, Kim L, et al. The incidence and significance of late acute cellular rejection (〖HT7〖JX-*7>HT61 000 days) after liver transplantation [J]. Clin Transplant， 2004; 18(2)∶152.
15.	Vennarecci G, Pisani F, Tisone G, et al. Kidney transplantation and pregnancy [J]. Transplant Proc， 1997; 29(7)∶2797.
16.	OldakowskaJedynak U, Niewczas M, Ziolkowski J, et al. Cytomegalovirus infection as a common complication following liver transplantation [J]. Transplant Proc， 2003; 35(6)∶2295.
17.	Seehofer D, Meisel H, Rayes N, et al. Prospective evaluation of the clinical utility of different methods for the detection of human cytomegalovirus disease after liver transplantation [J]. Am J Transplant， 2004; 4(8)∶1331.
18.	Revello MG, Gerna G. Diagnosis and management of human cytomegalovirus infection in the mother, fetus, and newborn infant [J]. Clin Microbiol Rev， 2002; 15(4)∶680.
19.	Fowler KB, Stagno S, Pass RF, et al. The outcome of congenital cytomegalovirus infection in relation to maternal antibody status [J]. N Engl J Med， 1992; 326(10)∶663.
20.	Schen FP, Stallone G, Schena A, et al. Pregnancy in renal transplantation: immunologic evaluation of neonates from mothers with transplanted kidney [J]. Transpl Immunol， 2002; 9(2-4)∶161.
21.	Laifer SA, Guido RS. Reproductive function and outcome of pregnancy after liver transplantation in women [J]. Mayo Clin Proc， 1995; 70(4)∶388.
22.	Tsai MY, Chang SY, Hsiu DY, et al. Pregnancy after orthotopic liver transplantation in a Chinese patient: a case report [J]. Changgeng Yi Xue Za Zhi， 1998; 21(1)∶67.

1. Mass K, Quint EH, Punch MR, et al. Gynecological and reproductive function after liver transplantation [J]. Transplantation, 1996; 62(4)∶476.
2. EBPG Expert Group on Renal Transplantation. European best practice guidelines for renal transplantation. Section Ⅳ: Longterm management of the transplant recipient. Ⅳ.10. Pregnancy in renal transplant recipients [J]. Nephrol Dial Transplant， 2002; 17 Suppl 4∶1.
3. Jain A, Venkataramanan R, Fung JJ, et al. Pregnancy after liver transplantation under tacrolimus [J]. Transplantation， 1997; 64(4)∶559.
4. Braun N, Dette S, Viebahn R. Impairment of renal function following liver transplantation [J]. Transplant Proc， 2003; 35(4)∶1458.
5. Sander M, Lyson T, Thomas GD, et al. Sympathetic neural mechanisms of cyclosporineinduced hypertension [J]. Am J Hypertens， 1996; 9(11)∶121S.
6. Armenti VT, Herrine SK, Radomski JS, et al. Pregnancy after liver transplantation [J]. Liver Transpl， 2000; 6(6)∶671.
7. Carr DB, Larson AM, Schmucker BC, et al. Maternal hemodynamics and pregnancy outcome in women with prior orthotopic liver transplantation [J]. Liver Transpl， 2000; 6(2)∶213.
8. Sturgiss SN, Davison JM. Perinatal outcome in renal allograft recipients: prognostic significance of hypertension and renal function before and during pregnancy [J]. Obstet Gynecol， 1991; 78(4)∶573.
9. Pruvot FR, Noel C. Comment on “Pregnancy after liver transplantation under tacrolimus” by Jain et al [J]. Transplantation， 1998; 65(10)∶1415.
10. Pruvot FR, Declerck N, ValatRigot AS, et al. Pregnancy after liver transplantation: focusing on risks to the mother [J]. Transplant Proc， 1997; 29(5)∶2470.
11. Armenti VT, Herrine SK, Moritz MJ. Reproductive function after liver transplantation [J]. Clin Liver Dis， 1997; 1(2)∶471.
12. Ratanajamit C, Vinther Skriver M, Jepsen P, et al. Adverse pregnancy outcome in women exposed to acyclovir during pregnancy: a populationbased observational study [J]. Scand J Infect Dis， 2003; 35(4)∶255.
13. Jain AB, Reyes J, Marcos A, et al. Pregnancy after liver transplantation with tacrolimus immunosuppression: a single center’s experience update at 13 years [J]. Transplantation， 2003; 76(5)∶827.
14. Florman S, Schiano T, Kim L, et al. The incidence and significance of late acute cellular rejection (〖HT7〖JX-*7>HT61 000 days) after liver transplantation [J]. Clin Transplant， 2004; 18(2)∶152.
15. Vennarecci G, Pisani F, Tisone G, et al. Kidney transplantation and pregnancy [J]. Transplant Proc， 1997; 29(7)∶2797.
16. OldakowskaJedynak U, Niewczas M, Ziolkowski J, et al. Cytomegalovirus infection as a common complication following liver transplantation [J]. Transplant Proc， 2003; 35(6)∶2295.
17. Seehofer D, Meisel H, Rayes N, et al. Prospective evaluation of the clinical utility of different methods for the detection of human cytomegalovirus disease after liver transplantation [J]. Am J Transplant， 2004; 4(8)∶1331.
18. Revello MG, Gerna G. Diagnosis and management of human cytomegalovirus infection in the mother, fetus, and newborn infant [J]. Clin Microbiol Rev， 2002; 15(4)∶680.
19. Fowler KB, Stagno S, Pass RF, et al. The outcome of congenital cytomegalovirus infection in relation to maternal antibody status [J]. N Engl J Med， 1992; 326(10)∶663.
20. Schen FP, Stallone G, Schena A, et al. Pregnancy in renal transplantation: immunologic evaluation of neonates from mothers with transplanted kidney [J]. Transpl Immunol， 2002; 9(2-4)∶161.
21. Laifer SA, Guido RS. Reproductive function and outcome of pregnancy after liver transplantation in women [J]. Mayo Clin Proc， 1995; 70(4)∶388.
22. Tsai MY, Chang SY, Hsiu DY, et al. Pregnancy after orthotopic liver transplantation in a Chinese patient: a case report [J]. Changgeng Yi Xue Za Zhi， 1998; 21(1)∶67.

《中國普外基礎與臨床雜志》

肝移植術后妊娠

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《中國普外基礎與臨床雜志》

肝移植術后妊娠

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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