Review
BibTex RIS Cite

Sexual Life, Pregnancy and Counseling After Renal Transplantation

Year 2022, Volume: 17 Issue: 3, 104 - 120, 30.09.2022
https://doi.org/10.47565/ndthdt.2022.59

Abstract

Kidney transplantation is considered the gold standard treatment for end-stage renal disease. Transplantation improves sexual health and quality of life by reducing the risk of death and increasing the chances of long-term survival. Approximately 40% of kidney transplant recipients are women and men who are able to become parents. Although kidney transplantation gives hope to kidney failure patients desiring to have children, transplantation brings some difficulties including sexual dysfunctions and unplanned pregnancies. Women receiving immunosuppressive therapy after kidney transplantation can be affected by sexual dysfunction, adverse pregnancy outcomes and breastfeeding concerns, and for men, sexual dysfunctions are common. Patient care and follow-up during the transplant process require a multidisciplinary team approach that includes a transplant surgeon, nephrologist, nephrology and transplant nurses, and organ transplant coordinator. Nephrology and transplantation nurses and other transplantation team members have important responsibilities before, during and after transplantation. To maximize the chances of graft survival and improve quality of life, nephrology and transplantation nurses need to take a holistic approach, and provide the patient with counseling on sexuality and reproduction, and also carefully manage pre- and post-operative care.

References

  • 1. Chaudhry D, Chaudhry A, Peracha J, Sharif A. Survival for waitlisted kidney failure patients receiving transplantation versus remaining on waiting list: systematic review and meta-analysis. BMJ. 2022 Mar 1;376:e068769. DOI: 10.1136/bmj-2021-068769.
  • 2. Sağlık Bakanlığı Organ, Doku Transplantasyonu ve Diyaliz Hizmetleri Daire Başkanlığı Güncel Veriler, Erişim Adresi: https://organkds.saglik.gov.tr/dss/PUBLIC/Transplant_Kidney.aspx Erişim Tarihi: 22.08. 2022.
  • 3. Agarwal KA, Pavlakis M. Sexuality, Contraception, and pregnancy in kidney transplantation. Kidney Med. 2021 Jul 29;3(5):837-847. DOI: 10.1016/j.xkme.2021.05.009.
  • 4. Hart A, Smith JM, Skeans MA, Gustafson SK, Wilk AR, Robinson A, et al. OPTN/SRTR 2016 annual data report: kidney. Am J Transplant. 2018 Jan;18 Suppl 1(Suppl 1):18-113. DOI: 10.1111/ajt.14557.
  • 5. Sikora-Grabka E, Adamczak M, Kuczera P, Wiecek A. Serum sex hormones concentrations in young women in the early period after successful kidney transplantation. Endokrynol. Pol. 2018;69:150–155. DOI: 10.5603/EP.2018.0019.
  • 6. Vranješ IM, Školka I, Jakab J, Krajina I, Krajina V, Šantić A, Zibar L. Sexual function in hemodialysis and post-renal transplant women in a relationship: a cross-sectional study. Int Urol Nephrol. 2022 Aug;54(8):2037-2046. DOI: 10.1007/s11255-021-03095-z.
  • 7. Abarca-Durán X, Fernández-Medina IM, Jiménez-Lasserrotte MDM, Dobarrio-Sanz I, Martínez-Abarca AL, Fernández-Sola C. Sexuality in kidney transplant recipients: a qualitative study. Healthcare (Basel). 2021 Oct 24;9(11):1432. DOI: 10.3390/healthcare9111432.
  • 8. Körükcü Ö, Boran ÖF, Güngör Ö, Boran M, Bakacak Z, Bozan MB, Çalışır F, Güzel FB, Kutludemırkol M. An underestimated human need after renal transplantation: sexuality. Sex Disabil 2020;38:699-714. DOI:10.1007/s11195-020-09647-y.
  • 9. Muehrer RJ, Lanuza DM, Brown RL, Djamali A. Sexual concerns among kidney transplant recipients. Clin Transplant. 2014 Nov;28(11):1294-302. DOI: 10.1111/ctr.12454.
  • 10. Jabali SS, Saleem ZSM, Mohammed AA, Mahmood NM. Erectile dysfunction pre and post kidney transplant recipients in Duhok city; cross sectional study. Ann Med Surg (Lond). 2020 May 16;55:107-110. DOI: 10.1016/j.amsu.2020.04.038.
  • 11. Pyrgidis N, Mykoniatis I, Tishukov M, Sokolakis I, Nigdelis MP, Sountoulides P, Hatzichristodoulou G, Hatzichristou D. Sexual dysfunction in women with end-stage renal disease: a systematic review and meta-analysis. J Sex Med. 2021 May;18(5):936-945. DOI: 10.1016/j.jsxm.2021.02.008.
  • 12. Kurtulus FO, Salman MY, Fazlioglu A, Fazlioglu B. Effects of renal transplantation on female sexual dysfunction: comparative study with hemodialysis and a control group. Transplant Proc. 2017 Nov;49(9):2099-2104. DOI: 10.1016/j.transproceed .2017.07.014. PMID: 29149968.
  • 13. Klein CL, Josephson MA. Post-transplant pregnancy and contraception. Clin J Am Soc Nephrol. 2022 Jan;17(1):114-120. DOI: 10.2215/CJN.14100820.
  • 14. Shah S, Venkatesan RL, Gupta A, Sanghavi MK, Welge J, Johansen R, Kean EB, Kaur T, Gupta A, Grant TJ, Verma P. Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review. BMC Nephrol. 2019 Jan 23;20(1):24. DOI: 10.1186/s12882-019-1213-5.
  • 15. Dines VA, Garovic VD, Parashuram S, Cosio FG, Kattah AG. Pregnancy, contraception, and menopause in advanced chronic kidney disease and kidney transplant. Womens Health Rep (New Rochelle). 2021 Oct 25;2(1):488-496. DOI: 10.1089/whr.2021.0053.
  • 16. Zahran MH, Elwasif SM, Khan I, Fakhreldin I, Elkasaby GE, El-Hefnawy AS, Osman Y, Ali-El-Dein B. The effect of renal transplantation on female sexual function: an age-matched pair analysis. Urology. 2022 Jul;165:164-169. DOI: 10.1016/j.urology.2022.01.029.
  • 17. Pizzol D, Xiao T, Yang L, Demurtas J, McDermott D, Garolla A, et al. Prevalence of erectile dysfunction in patients with chronic kidney disease: a systematic review and meta-analysis. Int J Impot Res. 2021 Jul;33(5):508-515. DOI: 10.1038/s41443-020-0295-8.
  • 18. Rahman IA, Rasyid N, Birowo P, Atmoko W. Effects of renal transplantation on erectile dysfunction: a systematic review and meta-analysis. Int J Impot Res. 2022 Aug;34(5):456-466. DOI: 10.1038/s41443-021-00419-6.
  • 19. Pyrgidis N, Mykoniatis I, Nigdelis MP, Kalyvianakis D, Memmos E, Sountoulides P, et al. Prevalence of erectile dysfunction in patients with end-stage renal disease: a systematic review and meta-analysis. J Sex Med. 2021 Jan;18(1):113-120. DOI: 10.1016/j.jsxm.2020.10.012.
  • 20. Salonia A, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, et al; EAU Working Group on Male Sexual and Reproductive Health. European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update: Male Sexual Dysfunction. Eur Urol. 2021 Sep;80(3):333-357. DOI: 10.1016/j.eururo.2021.06.007.
  • 21. Palmer BF, Clegg DJ. Gonadal dysfunction in chronic kidney disease. Rev Endocr Metab Disord. 2017 Mar;18(1):117-130. DOI: 10.1007/s11154-016-9385-9.
  • 22. Kazemeini SM, Mogharabian N, Asadpour A, Naderi G, Kasaeian A, Mousavi A. The effect of renal transplant on hypogonadism and erectile dysfunction due to end-stage renal disease. Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):923-928. DOI: 10.4103/1319-2442.338303.
  • 23. Luo L, Xiao C, Xiang Q, Zhu Z, Liu Y, Wang J, et al. Significant ıncrease of sexual dysfunction in patients with renal failure receiving renal replacement therapy: a systematic review and meta-analysis. J Sex Med. 2020 Dec;17(12):2382-2393. DOI: 10.1016/j.jsxm.2020.08.019.
  • 24. Spirito L, Manfredi C, Carrano R, Trinchieri A, Salemi F, Sciorio C, et al. Impact of kidney transplantation on male sexual function: results from a ten-year retrospective study. J Sex Med. 2020 Nov;17(11):2191-2197. DOI: 10.1016/j.jsxm.2020.07.014.
  • 25. Mota RL, Fonseca R, Santos JC, Covita AM, Marques N, Matias P, et al. Sexual dysfunction and satisfaction in kidney transplant patients. J Sex Med. 2019 Jul;16(7):1018-1028. DOI: 10.1016/j.jsxm.2019.03.266.
  • 26. Coscia LA, Constantinescu S, Moritz MJ, Frank AM, Ramirez CB, Maley WR, et al. Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. Clin Transpl. 2010:65-85.
  • 27. Mondal S, Sinha Roy PP, Pal DK. Sexual well-being and fertility in male renal transplant recipients: A study in a tertiary care centre. Urologia. 2022 Jul 27:3915603221114612. DOI: 10.1177/03915603221114612.
  • 28. Rovira J, Diekmann F, Ramírez-Bajo MJ, Bañón-Maneus E, Moya-Rull D, Campistol JM. Sirolimus-associated testicular toxicity: detrimental but reversible. Transplantation. 2012 May 15;93(9):874-9. DOI: 10.1097/TP.0b013e31824bf1f0.
  • 29. Szypulska-Koziarska D, Wilk A, Marchelek-Myśliwiec M, Śleboda-Taront D, Wiszniewska B. Tacrolimus-Based Immunosuppressive Therapy Influences Sex Hormone Profile in Renal-Transplant Recipients-A Research Study. Biology (Basel). 2021 Jul 24;10(8):709. DOI: 10.3390/biology10080709.
  • 30. Josephson MA, McKay DB. Women and transplantation: fertility, sexuality, pregnancy, contraception. Adv Chronic Kidney Dis. 2013 Sep;20(5):433-40. DOI: 10.1053/j.ackd.2013.06.005. Erratum in: Adv Chronic Kidney Dis. 2014 Jan;21(1):114.
  • 31. Shah S, Christianson AL, Bumb S, Verma P. Contraceptive use among women with kidney transplants in the United States. J Nephrol. 2022 Mar;35(2):629-638. DOI: 10.1007/s40620-021-01181-0.
  • 32. Wiles K, Chappell L, Clark K, Elman L, Hall M, Lightstone L, et al. Clinical practice guideline on pregnancy and renal disease. BMC Nephrol. 2019 Oct 31;20(1):401. DOI: 10.1186/s12882-019-1560-2.
  • 33. Krajewski CM, Geetha D, Gomez-Lobo V. Contraceptive options for women with a history of solid-organ transplantation. Transplantation. 2013 May 27;95(10):1183-6. DOI: 10.1097/TP.0b013e31827c64de.
  • 34. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Jun 21;62(RR-05):1-60.
  • 35. Szpotanska-Sikorska M, Pietrzak B, Wielgos M. Contraceptive awareness and birth control selection in female kidney and liver transplant recipients. Contraception. 2014 Oct;90(4):435-9. DOI: 10.1016/j.contraception.2014.04.014.
  • 36. Schwarz A, Schmitt R, Einecke G, Keller F, Bode U, Haller H, et al. Graft function and pregnancy outcomes after kidney transplantation. BMC Nephrol. 2022 Jan 12;23(1):27. DOI: 10.1186/s12882-022-02665-2.
  • 37. Gill JS, Zalunardo N, Rose C, Tonelli M. The pregnancy rate and live birth rate in kidney transplant recipients. Am J Transplant. 2009 Jul;9(7):1541-9. DOI: 10.1111/j.1600-6143.2009.02662.x.
  • 38. Gonzalez Suarez ML, Parker AS, Cheungpasitporn W. Pregnancy in Kidney Transplant Recipients. Adv Chronic Kidney Dis. 2020 Nov;27(6):486-498. DOI: 10.1053/j.ackd.2020.06.004.
  • 39. Rose C, Gill J, Zalunardo N, Johnston O, Mehrotra A, Gill JS. Timing of Pregnancy After Kidney Transplantation and Risk of Allograft Failure. Am J Transplant. 2016 Aug;16(8):2360-7. DOI: 10.1111/ajt.13773.
  • 40. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009 Nov;9 Suppl 3:S1-155. DOI: 10.1111/j.1600-6143.2009.02834.x.
  • 41. McKay DB, Josephson MA, Armenti VT, August P, Coscia LA, Davis CL, et al. Reproduction and transplantation: report on the AST consensus conference on reproductive issues and transplantation. Am J Transplant. 2005;5(7):1592–1599. DOI: 10.1111/j.1600-6143.2005.00969.x.
  • 42. Cabiddu G, Spotti D, Gernone G, Santoro D, Moroni G, Gregorini G, Giacchino F, Attini R, Limardo M, Gammaro L, Todros T, Piccoli GB; Kidney and Pregnancy Study Group of the Italian Society of Nephrology. A best-practice position statement on pregnancy after kidney transplantation: focusing on the unsolved questions. The Kidney and Pregnancy Study Group of the Italian Society of Nephrology. J Nephrol. 2018 Oct;31(5):665-681. DOI: 10.1007/s40620-018-0499-x.
  • 43. Liang JL, Tiwari T, Moro P, Messonnier NE, Reingold A, Sawyer M, et al. Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2018 Apr 27;67(2):1-44. DOI: 10.15585/mmwr.rr6702a1.
  • 44. Cordero E, Bulnes-Ramos A, Aguilar-Guisado M, González Escribano F, Olivas I, Torre-Cisneros J, et al. Effect of Influenza Vaccination Inducing Antibody Mediated Rejection in Solid Organ Transplant Recipients. Front Immunol. 2020 Oct 6;11:1917. DOI: 10.3389/fimmu.2020.01917.
  • 45. Natori Y, Shiotsuka M, Slomovic J, Hoschler K, Ferreira V, Ashton P, et al. A Double-Blind, Randomized Trial of High-Dose vs Standard-Dose Influenza Vaccine in Adult Solid-Organ Transplant Recipients. Clin Infect Dis. 2018 May 17;66(11):1698-1704. DOI: 10.1093/cid/cix1082.
  • 46. Jones CE, Calvert A, Le Doare K. Vaccination in Pregnancy-Recent Developments. Pediatr Infect Dis J. 2018 Feb;37(2):191-193. DOI: 10.1097/INF.0000000000001822. Erratum in: Pediatr Infect Dis J. 2018 May;37(5):465.
  • 47. T.C. Sağlık Bakanlığı COVID-19 Aşısı Bilgilendirme Platformu. Erişim Adresi: https://covid19asi.saglik.gov.tr/arama? _Dil=1&p=gebeler, Erişim Tarihi:26.09.2022.
  • 48. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Erişim Adresi: https://www.covid19treatmentguidelines.nih.gov/. Erişim Tarihi: 22.09.2022.
  • 49. Bramham K, Nelson-Piercy C, Gao H, Pierce M, Bush N, Spark P, et al. Pregnancy in renal transplant recipients: a UK national cohort study. Clin J Am Soc Nephrol. 2013 Feb;8(2):290-8. DOI: 10.2215/CJN.06170612.
  • 50. Vannevel V, Claes K, Baud D, Vial Y, Golshayan D, Yoon EW, et al. Preeclampsia and Long-term Renal Function in Women Who Underwent Kidney Transplantation. Obstet Gynecol. 2018 Jan;131(1):57-62. DOI: 10.1097/AOG.0000000000002404.
  • 51. Shah S, Verma P. Overview of pregnancy in renal transplant patients. Int J Nephrol. 2016;2016:4539342. DOI: 10.1155/2016/4539342.
  • 52. Duley L, Meher S, Hunter KE, Seidler AL, Askie LM. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2019 Oct 30;2019(10):CD004659. DOI: 10.1002/14651858.CD004659.pub3.
  • 53. Leruez-Ville M, Foulon I, Pass R, Ville Y. Cytomegalovirus infection during pregnancy: state of the science. Am J Obstet Gynecol. 2020 Sep;223(3):330-349. DOI: 10.1016/j.ajog.2020.02.018.
  • 54. Morton A, Burke M, Morton A, Kumar S. Anaemia in chronic kidney disease pregnancy. Obstet Med. 2021 Jun;14(2):116-120. DOI: 10.1177/1753495X20948985.
  • 55. Özgür Y, Gücün M, Tanrıkulu S, Demirbaş ZE, Erkılınç G, Titiz İ, et al. Iron parameters as a graft function ındicator in renal transplant recipients. South. Clin. Ist. Euras. 2019;30(1):14-19. 10.14744/scie.2018.26928
  • 56. Goonewardene M, Shehata M, Hamad A. Anaemia in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2012 Feb;26(1):3-24. DOI: 10.1016/j.bpobgyn.2011.10.010.
  • 57. WHO. Anaemia. Erişim Adresi: https://www.who.int/health-topics/anaemia#tab=tab_1 Erişim Tarihi: 2.09.2022
  • 58. Aydın Z, Güneş M. Böbrek nakli sonrası gebelik. Med Bull Haseki 2019; 57:1-8. Erişim Adresi: https://cms.galenos.com.tr/Uploads/Article_25844/HTB-57-1.pdf. Erişim Tarihi: 26.09.2022.
  • 59. T.C. Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü. Gebelerde Demir Destek Programı Uyguluması Genelgesi. 2007. Erişim Adresi: https://www.saglik.gov.tr/yazdir?E9E32817A68F89A60774DDBFF1C4F4A5. Erişim Tarihi: 26.09.2022.
  • 60. van Buren MC, Schellekens A, Groenhof TKJ, van Reekum F, van de Wetering J, Paauw ND, et al. Long-term graft survival and graft function following pregnancy in kidney transplant recipients: a systematic review and meta-analysis. Transplantation. 2020 Aug;104(8):1675-1685. DOI: 10.1097/TP.0000000000003026.
  • 61. Piccoli GB, Alrukhaimi M, Liu ZH, Zakharova E, Levin A; World Kidney Day Steering Committee. What we do and do not know about women and kidney diseases - questions unanswered and answers unquestioned: Reflection on World Kidney Day and International Woman's Day. Nephrology (Carlton). 2018 Mar;23(3):199-209. DOI: 10.1111/nep.13193.
  • 62. WHO. Infant and young child feeding https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding. 9 June 2021.
  • 63. Moritz MJ, Constantinescu S, Coscia LA. Transplant pregnancy registry ınternational (TPRI); 2020. Transplant Pregnancy Registry International (TPRI) 2019 Annual Report.
  • 64. Lewis GJ, Lamont CA, Lee HA, Slapak M. Successful pregnancy in a renal transplant recipient taking cyclosporin A. Br Med J (Clin Res Ed). 1983 Feb 19;286(6365):603. DOI: 10.1136/bmj.286.6365.603.
  • 65. Behrens O, Kohlhaw K, Günter H, Wonigeit K, Niesert S. Nachweis von Cyclosporin A in der Muttermilch--ist Stillen kontraindiziert? [Detection of cyclosporin A in breast milk--is breast feeding contraindicated?]. Geburtshilfe Frauenheilkd. 1989 Feb;49(2):207-9. German. DOI: 10.1055/s-2008-1026581.
  • 66. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. DOI: 10.1542/peds.2013-1985.
  • 67. Constantinescu S, Pai A, Coscia LA, Davison JM, Moritz MJ, Armenti VT. Breast-feeding after transplantation. Best Pract Res Clin Obstet Gynaecol. 2014 Nov;28(8):1163-73. DOI: 10.1016/j.bpobgyn.2014.09.001.
  • 68. Jesudason S, Williamson A, Huuskes B, Hewawasam E. Parenthood with kidney failure: answering questions patients ask about pregnancy. Kidney Int Rep. 2022 Apr 29;7(7):1477-1492. DOI: 10.1016/j.ekir.2022.04.081. PMID: 35812283; PMCID: PMC9263253.
  • 69. Yang FC, Chen HM, Huang CM, Hsieh PL, Wang SS, Chen CM. The difficulties and needs of organ transplant recipients during postoperative care at home: A Systematic Review. Int J Environ Res Public Health. 2020 Aug 11;17(16):5798. DOI: 10.3390/ijerph17165798.
  • 70. Martell J, Rice EI, Crooks NK, Ko D, Muehrer RJ. What are patients saying about sex after a kidney or simultaneous kidney/pancreas transplant? Prog Transplant. 2015 Sep;25(3):251-6. DOI: 10.7182/pit2015912. PMID: 26308785.
  • 71. French VA, Davis JS, Sayles HS, Wu SS. Contraception and fertility awareness among women with solid organ transplants. Obstet Gynecol. 2013 Oct;122(4):809-814. DOI: 10.1097/AOG.0b013e3182a5eda9.
  • 72. Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, et al. U.S. Medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep. 2016 Jul 29;65(3):1-103. DOI: 10.15585/mmwr.rr6503a1.
  • 73. Murphy F. The role of the nurse in pre-renal transplantation. Br J Nurs. 2007 May 24-Jun 13;16(10):582-7. DOI: 10.12968/bjon.2007.16.10.23502.
  • 74. Hariharan S, McBride MA, Cherikh WS, Tolleris CB, Bresnahan BA, Johnson CP. Post-transplant renal function in the first year predicts long-term kidney transplant survival. Kidney Int. 2002 Jul;62(1):311-8. DOI: 10.1046/j.1523-1755.2002.00424.x.
  • 75. FDA Pregnancy Categories. Erişim Adresi: https://www.drugs.com/pregnancy-categories.html#:~:text=In %201979%2C%20the%20FDA%20established,the%20risk%20to%20benefit%20ratio . Erişim Tarihi: 05.09.2022.

Böbrek Transplantasyonu Sonrası Cinsel Yaşam, Gebelik ve Danışmanlık/Sexual Life, Pregnancy and Counseling After Renal Transplantation

Year 2022, Volume: 17 Issue: 3, 104 - 120, 30.09.2022
https://doi.org/10.47565/ndthdt.2022.59

Abstract

Özet
Böbrek transplantasyonu, son dönem böbrek yetersizliğinde altın standart tedavi olarak kabul edilmektedir. Transplantasyon uzun vadeli sağkalım ile birlikte, ölüm riskini azaltarak cinsel sağlığı ve yaşam kalitesini iyileştirmektedir. Böbrek nakli alıcılarının yaklaşık %40’ını doğurganlık çağındaki kadın ve erkekler oluşturmaktadır. Böbrek transplantasyonu, böbrek yetersizliği hastalarına anne veya baba olmak için bir umut ışığı olsa da transplantasyonun beraberinde getirdiği birtakım zorluk-lar yer almaktadır. Cinsel işlev bozuklukları ve plansız gebe-likler bunların başında gelmektedir. Böbrek transplantasyonu sonrası immünsupresif tedavi alan kadınlarda cinsel fonksiyon bozuklukları, olumsuz gebelik sonuçları, emzirme endişeleri görülürken, immünsupresif tedavi alan erkeklerde cinsel işlev bozuklukları sık görülmektedir. Nakil sürecinde hasta bakımı ve izlemi trasplant cerrahı, nefrolog, nefroloji, transplantasyon hemşireleri ve organ nakil koordinatörü vd. içeren multidisip-liner bir ekip yaklaşımı gerektirmektedir. Böbrek transplantas-yonu öncesi, sırası ve sonrası nefroloji ve transplantasyon hem-şireleri ile diğer nakil ekibine önemli sorumluluklar düşmek-tedir. Nefroloji ve transplantasyon hemşirelerinin hastaya bütüncül yaklaşarak cinsellik ve üreme konusunda danışmanlık vermesi ayrıca greftin sağkalımını ve yaşam kalitesini en üst düzeye çıkarmak için hastanın ameliyat öncesi ve sonrası bakımını yönetmesi gerekmektedir.

References

  • 1. Chaudhry D, Chaudhry A, Peracha J, Sharif A. Survival for waitlisted kidney failure patients receiving transplantation versus remaining on waiting list: systematic review and meta-analysis. BMJ. 2022 Mar 1;376:e068769. DOI: 10.1136/bmj-2021-068769.
  • 2. Sağlık Bakanlığı Organ, Doku Transplantasyonu ve Diyaliz Hizmetleri Daire Başkanlığı Güncel Veriler, Erişim Adresi: https://organkds.saglik.gov.tr/dss/PUBLIC/Transplant_Kidney.aspx Erişim Tarihi: 22.08. 2022.
  • 3. Agarwal KA, Pavlakis M. Sexuality, Contraception, and pregnancy in kidney transplantation. Kidney Med. 2021 Jul 29;3(5):837-847. DOI: 10.1016/j.xkme.2021.05.009.
  • 4. Hart A, Smith JM, Skeans MA, Gustafson SK, Wilk AR, Robinson A, et al. OPTN/SRTR 2016 annual data report: kidney. Am J Transplant. 2018 Jan;18 Suppl 1(Suppl 1):18-113. DOI: 10.1111/ajt.14557.
  • 5. Sikora-Grabka E, Adamczak M, Kuczera P, Wiecek A. Serum sex hormones concentrations in young women in the early period after successful kidney transplantation. Endokrynol. Pol. 2018;69:150–155. DOI: 10.5603/EP.2018.0019.
  • 6. Vranješ IM, Školka I, Jakab J, Krajina I, Krajina V, Šantić A, Zibar L. Sexual function in hemodialysis and post-renal transplant women in a relationship: a cross-sectional study. Int Urol Nephrol. 2022 Aug;54(8):2037-2046. DOI: 10.1007/s11255-021-03095-z.
  • 7. Abarca-Durán X, Fernández-Medina IM, Jiménez-Lasserrotte MDM, Dobarrio-Sanz I, Martínez-Abarca AL, Fernández-Sola C. Sexuality in kidney transplant recipients: a qualitative study. Healthcare (Basel). 2021 Oct 24;9(11):1432. DOI: 10.3390/healthcare9111432.
  • 8. Körükcü Ö, Boran ÖF, Güngör Ö, Boran M, Bakacak Z, Bozan MB, Çalışır F, Güzel FB, Kutludemırkol M. An underestimated human need after renal transplantation: sexuality. Sex Disabil 2020;38:699-714. DOI:10.1007/s11195-020-09647-y.
  • 9. Muehrer RJ, Lanuza DM, Brown RL, Djamali A. Sexual concerns among kidney transplant recipients. Clin Transplant. 2014 Nov;28(11):1294-302. DOI: 10.1111/ctr.12454.
  • 10. Jabali SS, Saleem ZSM, Mohammed AA, Mahmood NM. Erectile dysfunction pre and post kidney transplant recipients in Duhok city; cross sectional study. Ann Med Surg (Lond). 2020 May 16;55:107-110. DOI: 10.1016/j.amsu.2020.04.038.
  • 11. Pyrgidis N, Mykoniatis I, Tishukov M, Sokolakis I, Nigdelis MP, Sountoulides P, Hatzichristodoulou G, Hatzichristou D. Sexual dysfunction in women with end-stage renal disease: a systematic review and meta-analysis. J Sex Med. 2021 May;18(5):936-945. DOI: 10.1016/j.jsxm.2021.02.008.
  • 12. Kurtulus FO, Salman MY, Fazlioglu A, Fazlioglu B. Effects of renal transplantation on female sexual dysfunction: comparative study with hemodialysis and a control group. Transplant Proc. 2017 Nov;49(9):2099-2104. DOI: 10.1016/j.transproceed .2017.07.014. PMID: 29149968.
  • 13. Klein CL, Josephson MA. Post-transplant pregnancy and contraception. Clin J Am Soc Nephrol. 2022 Jan;17(1):114-120. DOI: 10.2215/CJN.14100820.
  • 14. Shah S, Venkatesan RL, Gupta A, Sanghavi MK, Welge J, Johansen R, Kean EB, Kaur T, Gupta A, Grant TJ, Verma P. Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review. BMC Nephrol. 2019 Jan 23;20(1):24. DOI: 10.1186/s12882-019-1213-5.
  • 15. Dines VA, Garovic VD, Parashuram S, Cosio FG, Kattah AG. Pregnancy, contraception, and menopause in advanced chronic kidney disease and kidney transplant. Womens Health Rep (New Rochelle). 2021 Oct 25;2(1):488-496. DOI: 10.1089/whr.2021.0053.
  • 16. Zahran MH, Elwasif SM, Khan I, Fakhreldin I, Elkasaby GE, El-Hefnawy AS, Osman Y, Ali-El-Dein B. The effect of renal transplantation on female sexual function: an age-matched pair analysis. Urology. 2022 Jul;165:164-169. DOI: 10.1016/j.urology.2022.01.029.
  • 17. Pizzol D, Xiao T, Yang L, Demurtas J, McDermott D, Garolla A, et al. Prevalence of erectile dysfunction in patients with chronic kidney disease: a systematic review and meta-analysis. Int J Impot Res. 2021 Jul;33(5):508-515. DOI: 10.1038/s41443-020-0295-8.
  • 18. Rahman IA, Rasyid N, Birowo P, Atmoko W. Effects of renal transplantation on erectile dysfunction: a systematic review and meta-analysis. Int J Impot Res. 2022 Aug;34(5):456-466. DOI: 10.1038/s41443-021-00419-6.
  • 19. Pyrgidis N, Mykoniatis I, Nigdelis MP, Kalyvianakis D, Memmos E, Sountoulides P, et al. Prevalence of erectile dysfunction in patients with end-stage renal disease: a systematic review and meta-analysis. J Sex Med. 2021 Jan;18(1):113-120. DOI: 10.1016/j.jsxm.2020.10.012.
  • 20. Salonia A, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, et al; EAU Working Group on Male Sexual and Reproductive Health. European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update: Male Sexual Dysfunction. Eur Urol. 2021 Sep;80(3):333-357. DOI: 10.1016/j.eururo.2021.06.007.
  • 21. Palmer BF, Clegg DJ. Gonadal dysfunction in chronic kidney disease. Rev Endocr Metab Disord. 2017 Mar;18(1):117-130. DOI: 10.1007/s11154-016-9385-9.
  • 22. Kazemeini SM, Mogharabian N, Asadpour A, Naderi G, Kasaeian A, Mousavi A. The effect of renal transplant on hypogonadism and erectile dysfunction due to end-stage renal disease. Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):923-928. DOI: 10.4103/1319-2442.338303.
  • 23. Luo L, Xiao C, Xiang Q, Zhu Z, Liu Y, Wang J, et al. Significant ıncrease of sexual dysfunction in patients with renal failure receiving renal replacement therapy: a systematic review and meta-analysis. J Sex Med. 2020 Dec;17(12):2382-2393. DOI: 10.1016/j.jsxm.2020.08.019.
  • 24. Spirito L, Manfredi C, Carrano R, Trinchieri A, Salemi F, Sciorio C, et al. Impact of kidney transplantation on male sexual function: results from a ten-year retrospective study. J Sex Med. 2020 Nov;17(11):2191-2197. DOI: 10.1016/j.jsxm.2020.07.014.
  • 25. Mota RL, Fonseca R, Santos JC, Covita AM, Marques N, Matias P, et al. Sexual dysfunction and satisfaction in kidney transplant patients. J Sex Med. 2019 Jul;16(7):1018-1028. DOI: 10.1016/j.jsxm.2019.03.266.
  • 26. Coscia LA, Constantinescu S, Moritz MJ, Frank AM, Ramirez CB, Maley WR, et al. Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. Clin Transpl. 2010:65-85.
  • 27. Mondal S, Sinha Roy PP, Pal DK. Sexual well-being and fertility in male renal transplant recipients: A study in a tertiary care centre. Urologia. 2022 Jul 27:3915603221114612. DOI: 10.1177/03915603221114612.
  • 28. Rovira J, Diekmann F, Ramírez-Bajo MJ, Bañón-Maneus E, Moya-Rull D, Campistol JM. Sirolimus-associated testicular toxicity: detrimental but reversible. Transplantation. 2012 May 15;93(9):874-9. DOI: 10.1097/TP.0b013e31824bf1f0.
  • 29. Szypulska-Koziarska D, Wilk A, Marchelek-Myśliwiec M, Śleboda-Taront D, Wiszniewska B. Tacrolimus-Based Immunosuppressive Therapy Influences Sex Hormone Profile in Renal-Transplant Recipients-A Research Study. Biology (Basel). 2021 Jul 24;10(8):709. DOI: 10.3390/biology10080709.
  • 30. Josephson MA, McKay DB. Women and transplantation: fertility, sexuality, pregnancy, contraception. Adv Chronic Kidney Dis. 2013 Sep;20(5):433-40. DOI: 10.1053/j.ackd.2013.06.005. Erratum in: Adv Chronic Kidney Dis. 2014 Jan;21(1):114.
  • 31. Shah S, Christianson AL, Bumb S, Verma P. Contraceptive use among women with kidney transplants in the United States. J Nephrol. 2022 Mar;35(2):629-638. DOI: 10.1007/s40620-021-01181-0.
  • 32. Wiles K, Chappell L, Clark K, Elman L, Hall M, Lightstone L, et al. Clinical practice guideline on pregnancy and renal disease. BMC Nephrol. 2019 Oct 31;20(1):401. DOI: 10.1186/s12882-019-1560-2.
  • 33. Krajewski CM, Geetha D, Gomez-Lobo V. Contraceptive options for women with a history of solid-organ transplantation. Transplantation. 2013 May 27;95(10):1183-6. DOI: 10.1097/TP.0b013e31827c64de.
  • 34. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Jun 21;62(RR-05):1-60.
  • 35. Szpotanska-Sikorska M, Pietrzak B, Wielgos M. Contraceptive awareness and birth control selection in female kidney and liver transplant recipients. Contraception. 2014 Oct;90(4):435-9. DOI: 10.1016/j.contraception.2014.04.014.
  • 36. Schwarz A, Schmitt R, Einecke G, Keller F, Bode U, Haller H, et al. Graft function and pregnancy outcomes after kidney transplantation. BMC Nephrol. 2022 Jan 12;23(1):27. DOI: 10.1186/s12882-022-02665-2.
  • 37. Gill JS, Zalunardo N, Rose C, Tonelli M. The pregnancy rate and live birth rate in kidney transplant recipients. Am J Transplant. 2009 Jul;9(7):1541-9. DOI: 10.1111/j.1600-6143.2009.02662.x.
  • 38. Gonzalez Suarez ML, Parker AS, Cheungpasitporn W. Pregnancy in Kidney Transplant Recipients. Adv Chronic Kidney Dis. 2020 Nov;27(6):486-498. DOI: 10.1053/j.ackd.2020.06.004.
  • 39. Rose C, Gill J, Zalunardo N, Johnston O, Mehrotra A, Gill JS. Timing of Pregnancy After Kidney Transplantation and Risk of Allograft Failure. Am J Transplant. 2016 Aug;16(8):2360-7. DOI: 10.1111/ajt.13773.
  • 40. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009 Nov;9 Suppl 3:S1-155. DOI: 10.1111/j.1600-6143.2009.02834.x.
  • 41. McKay DB, Josephson MA, Armenti VT, August P, Coscia LA, Davis CL, et al. Reproduction and transplantation: report on the AST consensus conference on reproductive issues and transplantation. Am J Transplant. 2005;5(7):1592–1599. DOI: 10.1111/j.1600-6143.2005.00969.x.
  • 42. Cabiddu G, Spotti D, Gernone G, Santoro D, Moroni G, Gregorini G, Giacchino F, Attini R, Limardo M, Gammaro L, Todros T, Piccoli GB; Kidney and Pregnancy Study Group of the Italian Society of Nephrology. A best-practice position statement on pregnancy after kidney transplantation: focusing on the unsolved questions. The Kidney and Pregnancy Study Group of the Italian Society of Nephrology. J Nephrol. 2018 Oct;31(5):665-681. DOI: 10.1007/s40620-018-0499-x.
  • 43. Liang JL, Tiwari T, Moro P, Messonnier NE, Reingold A, Sawyer M, et al. Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2018 Apr 27;67(2):1-44. DOI: 10.15585/mmwr.rr6702a1.
  • 44. Cordero E, Bulnes-Ramos A, Aguilar-Guisado M, González Escribano F, Olivas I, Torre-Cisneros J, et al. Effect of Influenza Vaccination Inducing Antibody Mediated Rejection in Solid Organ Transplant Recipients. Front Immunol. 2020 Oct 6;11:1917. DOI: 10.3389/fimmu.2020.01917.
  • 45. Natori Y, Shiotsuka M, Slomovic J, Hoschler K, Ferreira V, Ashton P, et al. A Double-Blind, Randomized Trial of High-Dose vs Standard-Dose Influenza Vaccine in Adult Solid-Organ Transplant Recipients. Clin Infect Dis. 2018 May 17;66(11):1698-1704. DOI: 10.1093/cid/cix1082.
  • 46. Jones CE, Calvert A, Le Doare K. Vaccination in Pregnancy-Recent Developments. Pediatr Infect Dis J. 2018 Feb;37(2):191-193. DOI: 10.1097/INF.0000000000001822. Erratum in: Pediatr Infect Dis J. 2018 May;37(5):465.
  • 47. T.C. Sağlık Bakanlığı COVID-19 Aşısı Bilgilendirme Platformu. Erişim Adresi: https://covid19asi.saglik.gov.tr/arama? _Dil=1&p=gebeler, Erişim Tarihi:26.09.2022.
  • 48. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Erişim Adresi: https://www.covid19treatmentguidelines.nih.gov/. Erişim Tarihi: 22.09.2022.
  • 49. Bramham K, Nelson-Piercy C, Gao H, Pierce M, Bush N, Spark P, et al. Pregnancy in renal transplant recipients: a UK national cohort study. Clin J Am Soc Nephrol. 2013 Feb;8(2):290-8. DOI: 10.2215/CJN.06170612.
  • 50. Vannevel V, Claes K, Baud D, Vial Y, Golshayan D, Yoon EW, et al. Preeclampsia and Long-term Renal Function in Women Who Underwent Kidney Transplantation. Obstet Gynecol. 2018 Jan;131(1):57-62. DOI: 10.1097/AOG.0000000000002404.
  • 51. Shah S, Verma P. Overview of pregnancy in renal transplant patients. Int J Nephrol. 2016;2016:4539342. DOI: 10.1155/2016/4539342.
  • 52. Duley L, Meher S, Hunter KE, Seidler AL, Askie LM. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2019 Oct 30;2019(10):CD004659. DOI: 10.1002/14651858.CD004659.pub3.
  • 53. Leruez-Ville M, Foulon I, Pass R, Ville Y. Cytomegalovirus infection during pregnancy: state of the science. Am J Obstet Gynecol. 2020 Sep;223(3):330-349. DOI: 10.1016/j.ajog.2020.02.018.
  • 54. Morton A, Burke M, Morton A, Kumar S. Anaemia in chronic kidney disease pregnancy. Obstet Med. 2021 Jun;14(2):116-120. DOI: 10.1177/1753495X20948985.
  • 55. Özgür Y, Gücün M, Tanrıkulu S, Demirbaş ZE, Erkılınç G, Titiz İ, et al. Iron parameters as a graft function ındicator in renal transplant recipients. South. Clin. Ist. Euras. 2019;30(1):14-19. 10.14744/scie.2018.26928
  • 56. Goonewardene M, Shehata M, Hamad A. Anaemia in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2012 Feb;26(1):3-24. DOI: 10.1016/j.bpobgyn.2011.10.010.
  • 57. WHO. Anaemia. Erişim Adresi: https://www.who.int/health-topics/anaemia#tab=tab_1 Erişim Tarihi: 2.09.2022
  • 58. Aydın Z, Güneş M. Böbrek nakli sonrası gebelik. Med Bull Haseki 2019; 57:1-8. Erişim Adresi: https://cms.galenos.com.tr/Uploads/Article_25844/HTB-57-1.pdf. Erişim Tarihi: 26.09.2022.
  • 59. T.C. Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü. Gebelerde Demir Destek Programı Uyguluması Genelgesi. 2007. Erişim Adresi: https://www.saglik.gov.tr/yazdir?E9E32817A68F89A60774DDBFF1C4F4A5. Erişim Tarihi: 26.09.2022.
  • 60. van Buren MC, Schellekens A, Groenhof TKJ, van Reekum F, van de Wetering J, Paauw ND, et al. Long-term graft survival and graft function following pregnancy in kidney transplant recipients: a systematic review and meta-analysis. Transplantation. 2020 Aug;104(8):1675-1685. DOI: 10.1097/TP.0000000000003026.
  • 61. Piccoli GB, Alrukhaimi M, Liu ZH, Zakharova E, Levin A; World Kidney Day Steering Committee. What we do and do not know about women and kidney diseases - questions unanswered and answers unquestioned: Reflection on World Kidney Day and International Woman's Day. Nephrology (Carlton). 2018 Mar;23(3):199-209. DOI: 10.1111/nep.13193.
  • 62. WHO. Infant and young child feeding https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding. 9 June 2021.
  • 63. Moritz MJ, Constantinescu S, Coscia LA. Transplant pregnancy registry ınternational (TPRI); 2020. Transplant Pregnancy Registry International (TPRI) 2019 Annual Report.
  • 64. Lewis GJ, Lamont CA, Lee HA, Slapak M. Successful pregnancy in a renal transplant recipient taking cyclosporin A. Br Med J (Clin Res Ed). 1983 Feb 19;286(6365):603. DOI: 10.1136/bmj.286.6365.603.
  • 65. Behrens O, Kohlhaw K, Günter H, Wonigeit K, Niesert S. Nachweis von Cyclosporin A in der Muttermilch--ist Stillen kontraindiziert? [Detection of cyclosporin A in breast milk--is breast feeding contraindicated?]. Geburtshilfe Frauenheilkd. 1989 Feb;49(2):207-9. German. DOI: 10.1055/s-2008-1026581.
  • 66. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. DOI: 10.1542/peds.2013-1985.
  • 67. Constantinescu S, Pai A, Coscia LA, Davison JM, Moritz MJ, Armenti VT. Breast-feeding after transplantation. Best Pract Res Clin Obstet Gynaecol. 2014 Nov;28(8):1163-73. DOI: 10.1016/j.bpobgyn.2014.09.001.
  • 68. Jesudason S, Williamson A, Huuskes B, Hewawasam E. Parenthood with kidney failure: answering questions patients ask about pregnancy. Kidney Int Rep. 2022 Apr 29;7(7):1477-1492. DOI: 10.1016/j.ekir.2022.04.081. PMID: 35812283; PMCID: PMC9263253.
  • 69. Yang FC, Chen HM, Huang CM, Hsieh PL, Wang SS, Chen CM. The difficulties and needs of organ transplant recipients during postoperative care at home: A Systematic Review. Int J Environ Res Public Health. 2020 Aug 11;17(16):5798. DOI: 10.3390/ijerph17165798.
  • 70. Martell J, Rice EI, Crooks NK, Ko D, Muehrer RJ. What are patients saying about sex after a kidney or simultaneous kidney/pancreas transplant? Prog Transplant. 2015 Sep;25(3):251-6. DOI: 10.7182/pit2015912. PMID: 26308785.
  • 71. French VA, Davis JS, Sayles HS, Wu SS. Contraception and fertility awareness among women with solid organ transplants. Obstet Gynecol. 2013 Oct;122(4):809-814. DOI: 10.1097/AOG.0b013e3182a5eda9.
  • 72. Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, et al. U.S. Medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep. 2016 Jul 29;65(3):1-103. DOI: 10.15585/mmwr.rr6503a1.
  • 73. Murphy F. The role of the nurse in pre-renal transplantation. Br J Nurs. 2007 May 24-Jun 13;16(10):582-7. DOI: 10.12968/bjon.2007.16.10.23502.
  • 74. Hariharan S, McBride MA, Cherikh WS, Tolleris CB, Bresnahan BA, Johnson CP. Post-transplant renal function in the first year predicts long-term kidney transplant survival. Kidney Int. 2002 Jul;62(1):311-8. DOI: 10.1046/j.1523-1755.2002.00424.x.
  • 75. FDA Pregnancy Categories. Erişim Adresi: https://www.drugs.com/pregnancy-categories.html#:~:text=In %201979%2C%20the%20FDA%20established,the%20risk%20to%20benefit%20ratio . Erişim Tarihi: 05.09.2022.
There are 75 citations in total.

Details

Primary Language Turkish
Subjects Nursing
Journal Section Article
Authors

Özgül Karayurt 0000-0002-8642-0860

Adile Savsar 0000-0002-3401-6807

Publication Date September 30, 2022
Published in Issue Year 2022 Volume: 17 Issue: 3

Cite

Vancouver Karayurt Ö, Savsar A. Böbrek Transplantasyonu Sonrası Cinsel Yaşam, Gebelik ve Danışmanlık/Sexual Life, Pregnancy and Counseling After Renal Transplantation. JoNN. 2022;17(3):104-20.

Journal of Nephrology Nursing is licensed  Creative Commons Licenseunder a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.