Yusuf YILDIRIM, Seyhan SÖNMEZ, Emrah TÖZ, Murat İNAL, Ahmet AYKAS, Adam USLU

SOLİD ORGAN (BÖBREK, KARACİĞER, PANKREAS-BÖBREK, KALP, AKCİĞER VE KALP-AKCİĞER) TRANSPLANTASYONU VE GEBELİK

Reprodüktif çağdaki kadınlarda solid organ transplantasyonu sıklığı ve çeşitliliği her geçen yıl artmaktadır. Transplantla ilişkili gebeliklerin çoğu böbrek allogreftli kadınlarda bildirilmesine rağmen; karaciğer, pankreas-böbrek, kalp, akciğer ve kalp-akciğer transplantları gibi diğer solid organ transplantlı genç kadınlarda da gebelik mümkündür. Bu gebeliklerin çoğu başarılı bir akibetle sonuçlanmaktadır; bununla birlikte, optimal maternal ve neonatal sonuç için, obstetrisyen ve transplant ekibinin dikkatli takiplerini içeren multidisipliner bir yaklaşım esastır. Bu çalışma National Transplantation Pregnancy Registry (NTPR)’ninkiler başta olmak üzere daha önce yayınlanmış raporları göz önünde bulundurarak, çeşitli solid organ transplantlı kadınlarda prekonsepsiyonel danışmanlık, gebelik sırasında greft rejeksiyonu ve disfonksiyonu, immunsupresif tedavinin fetus açısından güvenilirliği ve perinatal riskler ve gebelik yönetimini gözden geçirmekte ve tartışmaktadır.

Anahtar Kelimeler:

Solid Organ Transplantasyonu, Gebelik, Komplikasyonlar

SOLID ORGAN (KIDNEY, LIVER, PANCREAS-KIDNEY, HEART, LUNG AND HEARTLUNG) TRANSPLANTATIONS AND PREGNANCY

The frequency and variety of solid organ transplantation in reproductive-age women increases each year. Although most transplant-related pregnancies have been reported in women with kidney allografts, pregnancy is also possible in young women with other solid organ transplants including liver, pancreaskidney, heart, lung and heart-lung transplants. Most of these pregnancies have resulted in a successfull outcome; however, for optimal maternal and neonatal outcomes, a multidisciplinary approach including careful follow-ups of the obstetrician and transplant team is essential. This article reviews and discusses preconceptional counselling, graft rejection and dysfunction during pregnancy, safety of immunosuppressive medications with regard to fetus, and perinatal risks and pregnancy management for women with various solid organ transplants, taking into consideration previous published reports, especially The National Transplantation Pregnancy Registry (NTPR)’s

Keywords:

Solid Organ Transplantation, Pregnancy, Complications,

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