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怀孕对移植患者死亡率和移植结果的长期影响:系统性审查和元分析
Mehmet Kanbay1, Crischentian Brinza2,3, Lasin Ozbek4
1Department of Medicine, Division of Nephrology, Koc University School of Medicine, 34010, Istanbul, Turkey. mkanbay@ku.edu.tr.
International urology and nephrology
|May 10, 2025
概括
移植受体的怀孕不会显著影响长期的移植存活率或患者死亡率. 然而,孕妇患者经历的不良结果略高,产后肌水平增加,需要量身定制的后续方案.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 生殖医学是一种生殖医学.
背景情况:
- 怀孕后脏移植带来了独特的生理挑战.
- 关于长期移植功能和怀孕后的存活率的现有数据是相互矛盾的.
- 需要进行全面审查,以澄清风险和结果.
研究的目的:
- 系统地审查和元分析怀孕对移植接受者的长期影响.
- 评估对患者生存,移植失败和功能标志物 (肌素,EGFR,蛋白尿) 的影响.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 在多个数据库中进行了搜索 (PubMed,Scopus,Web of Science等). ) 的情况.
- 包括了成年移植接受者在移植后怀孕和对照组的研究.
主要成果:
- 包括19项研究;怀孕和非怀孕的接受者之间在全移植失败风险 (OR 1.13) 或所有原因死亡率 (OR 0.63) 中没有显著差异.
- 在孕妇患者中观察到的不良结局率略高 (25.4%与19.8%相比).
- 在怀孕前,肌素水平明显低于分娩后 (SMD -0.33).
结论:
- 怀孕不会显著影响长期移植存活率或患者死亡率.
- 产后肌素水平增加,怀孕期间有三个月的具体变化.
- 最佳的后续方案至关重要,考虑到三个月特定的移植功能和建立干预值.
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