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您現在的位置: 醫(yī)學全在線 > 理論教學 > 外科學 > 臨床肝移植 > 正文:7-7 生育問題
    

7-7 生育問題

  術前月經失調(閉經、月經量少、不規(guī)則出血等),術后8-9個月后可以恢復正常。肝移植術后懷孕生育也時有報道[49]。有人認為,肝移植術后女性完全可以恢復正常的生育能力,但早產和剖宮產的概率較高。在懷孕期間,免疫抑制應該正常使用,但要注意監(jiān)測。至目前為止,還沒有致畸的報道。懷孕及生育不會增加排異反應的危險[50]。由于口服避孕藥會增加血液粘稠度,加重高血壓及藥物之間的反應,故肝移植術后病人不宜使用口服避孕藥。

  肝移植術后對男性生育能力的影響還未見報道。由于肝移植病人的下一代均未到生育年齡,因此對下一代生育能力有無影響也未見報道。

  參考文獻

  1.Grieg PD,Woolf GM,Sinclair T et al.Treatment of primary Liver grafts nonfunction with prostaglandin E1.Transplantation,1989,48:447

  2.Lange R,Erhard J,Rauen U et al.Determination of hepatocellular enzymes in effluent of human liver grafts for preoperative evaluation of transplant quality.Transplantation,1996,62:1255

  3.Rela M,Muiesan P,Bhatnagar V et al .Hepatic artery thrombosis after liver transplantation in children under 5years ofl age.Transplantation ,1996,61:1355

  4.Drazan K,Shaked A,Olthof KM et al .Etiology and management of symptomatic adult hepatic artery thrombosis after orthotopic liver transplantation(OLT).Am Surg,1996,62:237

  5.Jurim O,Csete M,Gelabert HA et al.Reduced-sized graft-the solution for heparic artery thrombosis after pediatric liver transplantation?J Pediatr Surg,1995,30:53

  6 Millis JM,Seaman DS,Piper JB et al.Portal vein thrombosis and stenosis in pediatric liver transplantation.Transplantation,1996,62:748

  7 Bhatnagar V,Dhawan A,Chaer H et al.The incidence and management of biliary complications following liver transplantation in chhldren,Transpl Int,1995,8:38

  8 Macfarlane B,Davidson B,Dooley JS et al.Endoscopic retrograde cholangiography in the diagnosis and endoscopic management op biliary complications.Eur J Gastroenterol Hepatol,1996,8:1003

  9 Khong PL,Sreeram N,John PR.Metallic sterting of biliary free following liver transplant hepatic artery thrombosis in an infant.Pediatr Rediol,1997,27:79

  10 Douzdjian V,Abecassis MM,Johlin FC.Sphincter of Oddi dysfunction following liver transplantation.Screening by bedside mainometry and definitive manometric evaluation.Dig Dis Sci,1994,39:253

  11 Haagsma EB,Thijn CJ,Post JG et al.Bone disease after orthotopic transplantation,J Hepatol,1988,6:94

  12 Stegall MD,Everson G,Schroter G et al.Metabolic complication after liver transplantation:diabetes,hypercholesterolemia,hypertension,and obesity,Transplantation,1995,60:1057

  13 Paller MC.The prostaglandin E1analogue,misoprostol analogue reverses acute cyclosporine nephrotoxicity.Transplant Proc,1988,20(Suppl 3):634

  14 Wijdicks EF Wiesner RH,Krom RA.Neurotoxity in liver transplant recipients with cyclosporine immnosuppression.Neurology,1995,45:1962

  15 Kabeer MH,Filo RS,Milgrom ML et al.Central pontine myelinolysis following orthotopic liver transplantation:association with cyclosporine toxicity.Postgrad Med J,1995,71:834;71:239

  16 Fryer JP,Fortier MV,Metrakos P et al.Central pontine myelinolysis and cyclosporine neurotoxicity following liver transplantation,Transplantation,1996,61:658

  17 Falagas ME,snydman DR,Griffith J et al.Effect of cytomegalovirus infection status or first-year mortality.Boston Center for Liver Transplantation CMV IgG Study Gfroup.Ann Intern Med,1997,126:275

  18 Vandenberg AP,Klompmaker IJ,Haagsma EB et al.Evidence for an increased rate of bacterial infections in liver transplant patients with cytomegalovirus infection,Clin Transplant,1996,10:224

  19 Falagas ME,Snydman DR,Ruthaxer R et al.Primary cytomegalovirus infection in liver transplant recipients:comparison of infections transmitted via donor organs and via transfusions.Boston Center for liver Transplantation CMV IgG Study Group.Clin Infect Dis,1996,23:292

  20 Winston DJ,wirin D,Shaked A et al.Randomized comparison of gancyclovir and high-dose acyclovir for long-term cytomegalovirus prophylaxis in liver transplant recipients.Lancet.1995,346:8967

  21 Kanj SS,Sharara AI,Clavien PA et al.Cytomegalovirus infection following liver transplantation:review of the literature.Clin Infect Dis,1996,22:537

  22 Stratta RJ,Shaefer MS,Cushing KA et al.A randomized prospective trial of acyclovir and immune globulin prophylaxis in liver transplant recipients receiving OKT3 therapy,Arch Surg,1992,127:55

  23 Liebau P,Kuse E,Windler M er al.Management of herpes simples virus type l pneumonia following liver transplantation,Infection,1996,24:130

  24 Lumbreras C,Cuervas-Mons V,Jara p et al,Randomized study of candida infection following liver transplantation,j Infect Dis,1996,174;583

  25 Torre-C,Cuervas-Mons V,Jara P et al.Effective of daily low-dose cotrimoxazole prophylaxis for Pneumocystis carinii pneumonia in liver transplantation- an open clinical trail.Transplantation,1996,62:1519

  26 Lynch SV,Strong RW.Primary cirrhosis:does it recur after transplantation?J Gastroenterol Hepatol,1989,4:109

  27 Anon.Is PBC cured by liver transplantation?Lancet,1991,337:272

  28 Knoop M,Bechstein WO,Schrem H et al.Clinical Significance of recurrent primary biliary cirrhosis after liver transplansplantation.Transpl Int,1996,9(Suppl 1):S115

  29 Van DE Water J,Gerson LB,Ferrell LD et al.Immunohistochemical evidence of disease recurrence after liver transplantation for primary biliary cirrhosis.Hepatology,1996,24:1079

  30 Sebagh M,Farges O,Kalil A et al.Sclerosing cholangitis following human orthotopic liver transplantation.Am J Surg pathol,1995,19:81

  31 Devlin J,Donaldson P,Portmann B et al.Recurrence of autoimmmune hepatitis following liver transplantation,Liver Transplant Surg,1995,1:162

  32 O'Grady JG,Williams R,Liver transplantation for viral hepatitis.Br Med Bull,1990,46:481

  33 Hart J,Busuttil RW,Lewin KJ.Disease recurrence following liver transplantation.Am J Surg Pathol,1990,14(Suppl 1):79

  34 Terrault NA,Zhou S,Combs C et al.Prophylaxis in liver transplant recipients using a fixed dosing schedule of hepatitis Bimmunoglobulin.Hepatology,1996,24:1327

  35 McGory RW,Ishitani MB,Oliveira WM et al.Imprived ortcome of orthotopic liver transplantation for chromic hepatitis B cirrhosis with aggressive passive immunization.Transplantation,1996,61:1358

  36 Bain VG,Kneteman NW,Ma MM et al.Efficacy of lamivudine im chronic hepatitis B patients with active viral replication and decompensated cirrhosis undergong liver transplantation,Transplantation,1996,62:1456

  37 Grdllier L,Mutimer D,Ahmed M et al.Lamivudine prophylaxis against reinfection in liver transplantation for hepatitis B cirrhosis.Lancet,1996,348:9036

  38 Ben-Ari Z,Shmueli D,Mor E et al.Beneficial effect of lamivueine in recurrent hepatitis b after liver transplantation.Transplantation,1997,63:393

  39 Bartholomew MM,Jansen RW,Jeffers LJ et al.Hepatitis-B-virus resistance to lamivudine given for recurrent infection after orthotopic liver transplantation.Lancet,1997,349:9044

  40 Gish RG,Lau JY,Brook L at al.Gancyclovir treatment of hepatitis B virus infection in liver transplant recipients.Hepatology,1996,23:1

  41 Boker KH,Ringe B,Kroger M et al.Prostaglandin plus famciclovir-a new concept for the treatment of sever hepatitis B after liver transplantation. Transplantation,1994,57:1706

  42Haller GW,Bechstein WO,Neuhaus R et al.Famciclivir therapy for recurrent hepatitis B infection after transplantation.Transpl Int,1996,9(Suppl 1):S210

  43Neuhaus P,Steffer R,Blumhardt G et al.Experience with immunoprophylaxis and interferon therapy after liver transplantation in HBsAg-positive patients.Transplant Proc,1991,23:1522

  44 Cavallari A,Vivarelli M,D,Errico A et al.Fatal necrotizing pancreatitis caused by hepatitis B infection in a liver transplant recipients.J Hepatol,1995,22:685

  45 Schluger LK,Sheiner PA,Thung SN et al.Severe recurrent cholestatic hepatitis C following orthotopic liver transplantation.Hepatology,1996,23:971

  46 Gane EJ,Tibbs CJ,Ramage Jk et al.Ribavirin therapy for hepatitis C infection following liver transplantation.Transpl Int,1995,8:61

  47 Cattral MS,Krajden M,Wanless IR et al.A pilot study of ribavirin therapy for recurrent hepatitis C virus infection after liver transplantation.Transplantation,1996,61:1483

  48 Feray C,Samuel D,Gigou M et al.An open trial of interferon alfa recombinant for hepatitis c after liver transplantation:antiviral effects and risk of rejection.Hepatology,199,22:1084

  49 Skannal DG,Dunngy-Poythress LJ,Miodovnik M et al.Pregnancy in a combined liver and kidney transplant recipient with type 1 primary hyperosaluria.Obstet Gynecol,1995,86:641

  50 Laifer SA,Guido RS.Reproductive function and outcome of pregnancy after liver transplantation in women.Mayo Clin Proc,1995,70:388

  51 Killenberg PG,Clavien PA.Medical care of the liver transplant patient Massachusetts:Blackwell Sciemce Inc,1997:159

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