Abstract:

Objective To analyze the clinical effect of fertility follow-up management in 15 female renal transplant recipients，summarize appropriate follow-up strategies，and provide practical evidence for improving maternal and infant outcomes and ensuring the survival of transplanted kidneys. Methods A retrospective analysis was conducted on the clinical data of 15 female renal transplant recipients who received fertility followup management in Shaanxi Provincial People's Hospital and Tangdu Hospital from January 2018 to December 2024.The key measures of the whole-course follow-up management（pre-pregnancy，pregnancy，and post-partum）were summarized. Results The time from post-transplantation to preparation for pregnancy in the 15 female renal transplant recipients ranged from 24 to 64 months，with an average of（41 .67 ±11.03）months; the average age at delivery was（30 .13 ±3.14）years. The main immunosuppressant regimen during pregnancy was tacrolimus+azathioprine+methylprednisolone/prednisone（9 cases），and the blood drug concentrations were all up to standard. The average gestational week at termination of pregnancy was（34 .03 ±3.18）weeks，14 cases gave birth to live infants（live birthrate 93.33%），including 4 cases of full-term delivery（28 .57%）and 10 cases of premature delivery（71 .43%）. The main reasons for termination of pregnancy were preeclampsia（4 cases）and deterioration of renal function（3 cases）， and the main mode of delivery was cesarean section（13 cases，92.86%）. No severe congenital malformations were found in neonates，and their growth and development were normal during follow-up. Two cases had deterioration of renal function after delivery and required hemodialysis. Conclusion The implementation of a multidisciplinary follow-up program of "pre-pregnancy evaluation—precise pregnancy monitoring—post-partum continuous management" for female renal transplant recipients can effectively improve the full-term delivery rate and ensure maternal and infant safety as well as the long-term stability of transplanted kidneys.

Key words:

text-indent:0pt, vertical-align:middle, "> Female renal transplant recipients, Fertility follow-up, Maternal and infantoutcomes, Transplanted kidney function, Immunosuppressants

摘要：

目的 分析15 例女性肾移植受者生育随访管理的临床效果，总结合适的随访策略，为改善肾移植受者的母婴结局及保障移植肾存活提供实践依据。 方法 回顾性分析2018 年1 月至2024 年12 月在陕西省人民医院、空军军医大学唐都医院接受生育随访管理的15 例女性肾移植受者的临床资料，总结“孕前—孕期—产后”全程随访管理的关键措施。 结果 15 例女性肾移植受者术后至备孕时间为24～64 个月，平均为（41.67 ±11.03）个月，平均分娩年龄为（30 .13 ±3.14）岁，孕期免疫抑制剂方案以他克莫司＋硫唑嘌呤+ 甲泼尼龙/ 泼尼松为主（9 例），孕期他克莫司/ 环孢素血药浓度达标。平均终止妊娠周为（34 .03 ±3.18）周，14 例诞下活产儿（活产率为93 .33%），其中足月分娩4 例（28 .57%），早产10 例（71 .43%）。终止妊娠原因以子痫前期（4 例）、肾功能恶化（3 例）为主，分娩方式以剖宫产为主（13 例，92.86%）。新生儿无严重先天畸形，随访生长发育正常。2 例产后肾功能恶化需血液透析。 结论 实施“孕前评估—孕期协同—产后延续管理”的多学科全程随访方案，可有效提升活产率，保障母婴安全及移植肾长期稳定。

关键词:

text-indent:0pt, vertical-align:middle, "> 女性肾移植受者, 生育随访, 母婴结局, 移植肾功能, 免疫抑制剂