Abstract
BACKGROUNDD 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 METHODSFrom 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. RESULTSIn 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. CONCLUSIONAlthough 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.
Original language | English |
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Pages (from-to) | 100-104 |
Number of pages | 5 |
Journal | Transfusion |
Volume | 58 |
Issue number | 1 |
DOIs | |
Publication status | Published - 1 Jan 2018 |
Keywords
- RENAL-TRANSPLANTATION
- HEMOLYTIC-DISEASE
- RHD ANTIBODIES
- IMMUNIZATION
- PERSISTENCE
- PREGNANCY
- NEWBORN