{"title":"剖宫产术中肾肝移植受者的麻醉管理。","authors":"Aynur Camkıran Fırat, Asude Ayhan, Coşkun Araz, Nükhet Akovalı, Zeynep Kayhan","doi":"10.5152/TJAR.2023.22033","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to present our experience in liver transplantation recipients and renal transplantation recipients during caesarean section.</p><p><strong>Methods: </strong>Retrospective data regarding liver transplantation recipients and renal transplantation recipients who underwent caesarean section between January 1997 and January 2017 have been collected from the hospital records.</p><p><strong>Results: </strong>Fourteen live births occurred from 5 liver transplantation recipients and 9 renal transplantation recipients, all of them from caesarean section. The mean maternal age (28.4 ± 4.0 years vs. 29.2 ± 4.1 years, P = .38), body weight before conception (57.4 ± 8.8 kg vs. 64.5 ± 8.2 kg, P = .48), and the time from transplantation to conception (99.0 ± 50.7 months vs. 101.0 ± 57.5 months, P = .46) were similar for 5 liver transplantation recipients and 9 renal transplantation recipients, respectively. Four caesarean sections were performed under general anaesthesia, whereas spinal anaesthesia was used in 10 patients. The mean birth weight was similar (2502 ± 311g vs. 2161 ± 658 g, P = .3). There were 3 premature deliveries in liver transplantation recipients versus 6 premature deliveries in renal transplantation recipients and 2 low-birth-weight infants (<2500 g) in liver transplantation recipients versus 4 in renal transplantation recipients among 14 newborns. Infants small for gestational age were diagnosed in 9/14 (3 liver transplantation recipients versus 6 renal transplantation recipients, P = 1).</p><p><strong>Conclusion: </strong>General and regional anaesthesia can be safely used during caesarean delivery of liver transplantation recipients and renal transplantation recipients without increased risk of graft losses. Prematurity and low birth weight were mainly due to the cytotoxic drugs for immunosuppression. There are no differences in liver transplantation recipients and renal transplantation recipients for maternal and foetal complications according to our data.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 2","pages":"85-89"},"PeriodicalIF":0.6000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210931/pdf/","citationCount":"0","resultStr":"{\"title\":\"Anaesthetic Management of Renal and Liver Transplantation Recipients During Caesarean Section.\",\"authors\":\"Aynur Camkıran Fırat, Asude Ayhan, Coşkun Araz, Nükhet Akovalı, Zeynep Kayhan\",\"doi\":\"10.5152/TJAR.2023.22033\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The aim of this study was to present our experience in liver transplantation recipients and renal transplantation recipients during caesarean section.</p><p><strong>Methods: </strong>Retrospective data regarding liver transplantation recipients and renal transplantation recipients who underwent caesarean section between January 1997 and January 2017 have been collected from the hospital records.</p><p><strong>Results: </strong>Fourteen live births occurred from 5 liver transplantation recipients and 9 renal transplantation recipients, all of them from caesarean section. The mean maternal age (28.4 ± 4.0 years vs. 29.2 ± 4.1 years, P = .38), body weight before conception (57.4 ± 8.8 kg vs. 64.5 ± 8.2 kg, P = .48), and the time from transplantation to conception (99.0 ± 50.7 months vs. 101.0 ± 57.5 months, P = .46) were similar for 5 liver transplantation recipients and 9 renal transplantation recipients, respectively. Four caesarean sections were performed under general anaesthesia, whereas spinal anaesthesia was used in 10 patients. The mean birth weight was similar (2502 ± 311g vs. 2161 ± 658 g, P = .3). There were 3 premature deliveries in liver transplantation recipients versus 6 premature deliveries in renal transplantation recipients and 2 low-birth-weight infants (<2500 g) in liver transplantation recipients versus 4 in renal transplantation recipients among 14 newborns. Infants small for gestational age were diagnosed in 9/14 (3 liver transplantation recipients versus 6 renal transplantation recipients, P = 1).</p><p><strong>Conclusion: </strong>General and regional anaesthesia can be safely used during caesarean delivery of liver transplantation recipients and renal transplantation recipients without increased risk of graft losses. Prematurity and low birth weight were mainly due to the cytotoxic drugs for immunosuppression. There are no differences in liver transplantation recipients and renal transplantation recipients for maternal and foetal complications according to our data.</p>\",\"PeriodicalId\":23353,\"journal\":{\"name\":\"Turkish journal of anaesthesiology and reanimation\",\"volume\":\"51 2\",\"pages\":\"85-89\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210931/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Turkish journal of anaesthesiology and reanimation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5152/TJAR.2023.22033\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Turkish journal of anaesthesiology and reanimation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5152/TJAR.2023.22033","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:本研究的目的是介绍我们在剖宫产术中肝移植和肾移植患者的经验。方法:回顾性收集1997年1月至2017年1月间行剖宫产手术的肝移植受者和肾移植受者的病历资料。结果:肝移植5例，肾移植9例，术后14例活产，均为剖腹产手术。5例肝移植受者和9例肾移植受者的平均产妇年龄(28.4±4.0岁比29.2±4.1岁，P = 0.38)、孕前体重(57.4±8.8 kg比64.5±8.2 kg, P = 0.48)、移植至受胎时间(99.0±50.7个月比101.0±57.5个月，P = 0.46)相似。4例剖宫产在全身麻醉下进行，10例采用脊髓麻醉。平均出生体重相似(2502±311g vs. 2161±658 g, P = 0.3)。肝移植受者早产3例，肾移植受者早产6例，低出生体重儿早产2例(结论:肝移植受者和肾移植受者剖宫产时可安全使用全身和区域麻醉，且不会增加移植物丢失的风险。早产和低出生体重的主要原因是细胞毒性免疫抑制药物。根据我们的数据，肝移植受体和肾移植受体在母胎并发症方面没有差异。
Anaesthetic Management of Renal and Liver Transplantation Recipients During Caesarean Section.
Objective: The aim of this study was to present our experience in liver transplantation recipients and renal transplantation recipients during caesarean section.
Methods: Retrospective data regarding liver transplantation recipients and renal transplantation recipients who underwent caesarean section between January 1997 and January 2017 have been collected from the hospital records.
Results: Fourteen live births occurred from 5 liver transplantation recipients and 9 renal transplantation recipients, all of them from caesarean section. The mean maternal age (28.4 ± 4.0 years vs. 29.2 ± 4.1 years, P = .38), body weight before conception (57.4 ± 8.8 kg vs. 64.5 ± 8.2 kg, P = .48), and the time from transplantation to conception (99.0 ± 50.7 months vs. 101.0 ± 57.5 months, P = .46) were similar for 5 liver transplantation recipients and 9 renal transplantation recipients, respectively. Four caesarean sections were performed under general anaesthesia, whereas spinal anaesthesia was used in 10 patients. The mean birth weight was similar (2502 ± 311g vs. 2161 ± 658 g, P = .3). There were 3 premature deliveries in liver transplantation recipients versus 6 premature deliveries in renal transplantation recipients and 2 low-birth-weight infants (<2500 g) in liver transplantation recipients versus 4 in renal transplantation recipients among 14 newborns. Infants small for gestational age were diagnosed in 9/14 (3 liver transplantation recipients versus 6 renal transplantation recipients, P = 1).
Conclusion: General and regional anaesthesia can be safely used during caesarean delivery of liver transplantation recipients and renal transplantation recipients without increased risk of graft losses. Prematurity and low birth weight were mainly due to the cytotoxic drugs for immunosuppression. There are no differences in liver transplantation recipients and renal transplantation recipients for maternal and foetal complications according to our data.
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