实体器官移植后的女性:妇科健康概述

Cássia Raquel Teatin Juliato, José Paulo Guida, Fernanda Surita
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摘要

随着移植后存活率的提高和女性器官受者人数的增加,仔细考虑这些女性的生殖和妇科健康问题显得尤为重要。人们关注的主要问题之一是移植后罹患癌症的风险增加,部分原因是使用了免疫抑制疗法。与病毒感染关系密切的妇科癌症(如宫颈癌)应得到特别护理和筛查,尤其是在年轻女性中。此外,由于宫颈癌可以预防,因此在接受移植手术前必须接种疫苗。乳腺癌是另一种因发病率高而特别值得关注的妇科癌症,移植人群应按照普通人群的指南进行筛查。生育能力和计划生育也是重要的考虑因素,因为大多数女性在移植后会恢复排卵和月经。建议采用可逆的长效避孕方法等避孕策略,因为这些方法有效且失败率低。还应评估激素避孕药和免疫抑制剂的使用情况,并强调需要仔细监测潜在的药物相互作用。对实体器官移植后妇女的妇科健康采取综合方法可使移植物的健康和妇女的妇科健康都获得更好的结果,从而改善患者的预后。持续跟踪、仔细监测、预防癌症以及有效管理生育和避孕对于确保她们的生活质量和幸福至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Women After Solid Organ Transplantation: An Overview of Gynecological Health
The increase in survival after transplantation and the growth of the female organ recipient population underscore the importance of carefully considering the reproductive and gynecological health of these women. One of the main concerns is the increased risk of cancer after transplantation, partly attributed to the use of immunosuppressive therapy. Gynecological cancers with a high association with viral infections, such as cervical cancer, should receive specific care and screening, especially among younger women. Additionally, the preventable nature of cervical cancer makes vaccination mandatory before undergoing transplantation. Breast cancer, another gynecological cancer of special interest due to its high prevalence, should be screened in the transplant population following guidelines for the general population. Fertility and family planning are also important considerations, as most women experience the return of ovulation and menstruation after transplantation. Contraception strategies, such as reversible long-acting methods, are recommended due to their effectiveness and low failure rate. The use of hormonal contraceptives and immunosuppressants should also be evaluated, emphasizing the need to carefully monitor potential drug interactions. An integrated approach to the gynecological health of women after solid organ transplantation enables better outcomes for both graft health and the gynecological health of the woman, resulting in improved outcomes for the patient. Ongoing follow-up, careful surveillance, cancer prevention, and effective management of fertility and contraception are crucial to ensure their quality of life and well-being.
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