The development of D antibodies after D-mismatched kidney transplantation in a setting of reduced immunosuppression.

Autor: Habets THPM; Transplantation Immunology, Tissue Typing Laboratory.; Department of Internal Medicine, Division of Hematology., Vanderlocht J; Central Diagnostic Laboratory, Cluster for Hemostasis and Transfusion., Straat RJMHE; Central Diagnostic Laboratory, Cluster for Hemostasis and Transfusion., van Smaalen TC; Department of Surgery., Bos GMJ; Department of Internal Medicine, Division of Hematology.; CiMaas BV, Maastricht, The Netherlands., Beckers EA; Department of Internal Medicine, Division of Hematology., Christiaans MHL; Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center., Henskens YMC; Central Diagnostic Laboratory, Cluster for Hemostasis and Transfusion.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2018 Jan; Vol. 58 (1), pp. 100-104. Date of Electronic Publication: 2017 Nov 29.
DOI: 10.1111/trf.14405
Abstrakt: Background: D antigens are not taken into account in the allocation of solid organs. Female transplant recipients with D antibodies as a consequence of D-mismatched kidney transplantation may develop hemolytic disease of the fetus and newborn in future pregnancies. We examined D antibody development in transplant recipients who received D-mismatched kidney transplantation in absence of D prophylaxis and in a setting of reduced immunosuppression.
Study Design and Methods: From 1993 until 2015, a total of 1355 kidney patients received transplantations in our center of whom 156 received a D-mismatched graft. A retrospective analysis was conducted; frozen stored sera obtained from transplant recipients 3 months after transplantation were tested for irregular red blood cell (RBC) antibodies using a three-cell screening and an identification panel. In the case of D antibody positivity, additional testing was performed 1 month before transplantation.
Results: In seven of 156 (4.5%) transplant recipients we found irregular RBC antibodies after transplantation, of which five (3.2%) were determined to be D antibodies. We observed only one (0.6%) recipient without D antibodies before transplantation.
Conclusion: Although the risk of D antibody development is considerably lower after D-mismatched kidney transplantation than D-mismatched pregnancy, anti-D prophylaxis may still be advisable for female transplant recipients of childbearing age.
(© 2017 AABB.)
Databáze: MEDLINE
Externí odkaz: