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Related Experiment Videos

Rhesus immunization after renal transplantation

V A Quan1, L J Kemp, A Payne

  • 1Department of Nephrology, UMDS, Guy's Hospital, London, United Kingdom.

Transplantation
|January 15, 1996
PubMed
Summary

Kidney transplant recipients who are RhD-negative can develop RhD antibodies after receiving an RhD-positive kidney. Prophylactic anti-D immunoglobulin is recommended for RhD-negative women of childbearing age undergoing transplantation.

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Area of Science:

  • Immunology
  • Transplantation Medicine
  • Nephrology

Background:

  • Previous reports indicated a risk of RhD antibody production after kidney transplantation before widespread cyclosporine use.
  • The immunogenicity of RhD-positive donor kidneys in RhD-negative recipients requires ongoing investigation, especially with modern immunosuppression.

Purpose of the Study:

  • To evaluate the incidence of primary RhD antibody production in RhD-negative kidney transplant recipients receiving RhD-positive kidneys.
  • To assess the implications of RhD immunization in the context of increasing pregnancies among transplant recipients.

Main Methods:

  • Retrospective and current evidence review.
  • Analysis of 42 RhD-negative renal transplant recipients on triple immunosuppressive therapy.
  • Identification of de novo RhD antibody production post-transplantation.

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Main Results:

  • Two out of 42 (5%) RhD-negative recipients developed primary RhD antibodies after receiving an RhD-positive kidney.
  • This finding highlights a persistent risk of RhD immunization despite current immunosuppressive regimens.

Conclusions:

  • RhD-negative women of childbearing age receiving an RhD-positive solid organ transplant are at risk of primary RhD immunization.
  • Prophylactic administration of 500 IU of anti-D immunoglobulin intramuscularly at transplantation is recommended for this patient group.
  • This measure aims to mitigate the risk of hemolytic disease of the newborn in future pregnancies.