Impact of pregnancy on allosensitization in women with fifth stage chronic kidney disease
Abstract
This analysis is devoted to the problem of the impact of pregnancy on allosensitization in women with chronic kidney disease of the fifth stage, and it in the choice of a donor and immunosuppression for kidney allotransplantation. The analysis showed that alloimmunization of pregnant women is a common occurrence, and still remains poorly understood. Research suggests that endogenous mechanisms that promote maternal fetal tolerance during pregnancy may persist into postpartum life. And it remains to be seen whether this immunological balance can be used to improve transplant outcomes. Thus, significant opportunities remain for clinical researchers to contribute to this area and improve transplant outcomes for sensitized women.
About the Author
I. M. Usmonov
National Scientific Center for Transplantation of Human Organs and Tissues, Ministry of Health and Social Protection of the Republic of Tajikistan
Tajikistan
Tajikistan
Usmonov I.M - Applicant, Department of Allergology and Immunology of the Institute of Postgraduate Education and Health of the Republic of Tajikistan
734064, Dushanbe.
Phone: +992918228595
References
1. Беркос А.С. Механизм развития гуморального иммунного ответа на аллогенную трансплантацию органов / А.С. Беркос, Г.В. Николаев // Вестник трансплантологии и искусственных органов. – 2017. – Т. 19, № 2. – С. 139-151.
2. Гулов М.К. Причины дисфункции трансплантата почки и методы её коррекции / М.К. Гулов, Б.С. Пиров // Вестник Авицены.- 2017. -№ 14 (19).-C. 532–536.
3. Хубутия М. Ш. Прогностические факторы риска развития ранних дисфункций трансплантата после родственной пересадки почки / М.Ш. Хубутия, М.К. Гулов, С.С. Исмоилов [и др.] //Здравоохранение Таджикистана. – 2016. – № 4. – С. 51-59.
4. Мурадов А.М. Некоторые факторы иммунологического риска у пациентов с терминальной стадией хронической болезни почек, находящихся на гемодиализной терапии / А.М. Мурадов [и др.] // Вестник Академии медицинских наук Таджикистана.- 2020.- Т. 10, № 3 (35).- C. 286–292.
5. Ajaimy M, Lubetzky M, Jones T, Kamal L, Colovai A, de Boccardo G, Akalin E. Pregnancy in sensitized kidney transplant recipients: a single-center experience. Clin Transpl, 2016, Vol 30(7), pp.791–5.
6. Akturk S, Celebi ZK, Erdogmus S, Kanmaz AG, Yuce T, Sengul S, Keven K. Pregnancy after kidney transplantation: outcomes, tacrolimus doses, and trough levels. Transplant Proc, Vol 2015, Vol 47(5),pp. 1442–4.
7. Guichard-Romero A., Marino-Vazquez L. A., Castelán N., et al. Impact of pretransplant exposure to allosensitization factors generating HLA antibodies in the Luminex era. Transplant Immunology, 2016, Vol 38: pp.33–39.
8. Yoshikawa Y, Uchida J, Akazawa C, Suganuma N. Analyses of relationship between obstetric complications and preterm delivery in Japanese recipients received kidney transplant. Transplantation, 2016, Vol 100(7), S884–5.
9. Laging M., Kal-van Gestel J. A., Haasnoot G. W., et al. Transplantation results of completely HLA-mismatched living and completely HLAmatched deceased-donor kidneys are comparable. Transplantation, 2014, Vol 97(3), pp. 330–336.
10. Kumbala D., Zhang R. Essential concept of transplant immunology for clinical practice. World Journal of Transplantation, 2013, Vol 3(4), pp.113–118.
11. Gombos P., Opelz G., Scherer S., et al. Influence of test technique on sensitization status of patients on the kidney transplant waiting list. American Journal of Transplantation, 2013, Vol 13(8), pp. 2075–2082.
12. Zachary A. A., Kopchaliiska D., Jackson A. M., Leffell M. S. Immunogenetics and immunology in transplantation. Immunologic Research, 2013, Vol 47(1-3), pp.232–239.
13. Devresse A, Jassogne C, Hubinont C, De Meyer M, Mourad M, Goffin E, Kanaan N. Maternal risks and pregnancy outcomes after kidney transplantation: a single center experience. Am J Transplant, 2017, Vol 17, pp. 253.
14. Rees L., Kim J. J. HLA sensitisation: can it be prevented? Pediatric Nephrology, 2015, Vol 30(4), pp. 577–587.
15. Hyun J., Park K. D., Yoo Y., et al. Effects of different sensitization events on HLA alloimmunization in solid organ transplantation patients. Transplantation Proceedings, 2012, Vol 44(1), pp.222–225.
16. Erman Akar M, Ozekinci M, Sanhal C, Kececioglu N, Mendilcioglu I, Senol Y, Dirican K, Kocak H, Dinckan A, Suleymanlar G. A retrospective analysis of pregnancy outcomes after kidney transplantation in a single center. Gynecol Obstet Investig, 2015, Vol 79(1), pp.13–8.
17. Jordan S. C., Choi J., Kahwaji J., Vo A. Complement inhibition for prevention and treatment of antibody-mediated rejection in renal allograft recipients. Transplantation Proceedings, 2016, Vol 48(3), pp.806–808.
18. Zhang R. Donor-specific antibodies in kidney transplant recipients. Clinical Journal of the American Society of Nephrology, 2017, Vol 13(1), pp.182–192.
19. Picascia A., Grimaldi V., Sabia C., Napoli C. Comprehensive assessment of sensitizing events and anti-HLA antibody development in women awaiting kidney transplantation. Transplant Immunology, 2016, Vol 36, pp. 14–19.
20. Everly M. J. Incidence and hazards of alloantibodies in renal transplantation. Clinical Transplants, 2013, pp. 313–317.
21. Obrador G. T., Macdougall I. C. Effect of red cell transfusions on future kidney transplantation. Clinical Journal of the American Society of Nephrology, 2012, Vol 8(5), pp. 852–860.
22. Lobashevsky A. L. Methodological aspects of anti-human leukocyte antigen antibody analysis in solid organ transplantation. World Journal of Transplantation, 2014, Vol 4(3), pp. 153–167.
23. Wiwattanathum P., Ingsathit A., Thammanichanond D., Mongkolsuk T., Sumethkul V. Significance of HLA antibody detected by PRAbead method in kidney transplant outcomes. Transplantation Proceedings, 2016, Vol 48(3), pp.761–765.
24. Bosch A., Llorente S., Eguia J., et al. HLA-C antibodies are associated with irreversible rejection in kidney transplantation: shared molecular eplets characterization. Human Immunology. 2014, Vol 75(4) pp. 338–341.
25. Chapel H., Haeney M., Misbah S., Snowden N. Essentials of Clinical Immunology. 6th. Wiley-Blackwell, 2014. pp. 1–377.
26. Haque W. M. M., Rahim M. A. Cross-matches in transplantation: each is complementary to other. BIRDEM Medical Journal, 2017, Vol 6 (2), pp. 118–126.
27. Sarkar R. S., Philip J., Yadav P. Transfusion medicine and solid organ transplant - update and review of some current issues. Medical Journal, Armed Forces India, 2013, Vol 69(2), pp. 162–167.
28. Santos S, Malheiro J, Campos A, Pedroso S, Almeida M, Martins LS, Dias L, Henriques C, Cabrita A. Pregnancy in renal transplant recipients: obstetric outcomes and risk of allosensitization. Medicine, 2016, Vol 95(10).
29. Akgul S., Ciftci H., Temurhan S., et al. Association between HLA antibodies and different sensitization events in renal transplant candidates. Transplantation Proceedings, 2017, Vol 49(3), pp. 425–429.
30. Higgins R., Lowe D., Daga S., et al. Pregnancy-induced HLA antibodies respond more vigorously after renal transplantation than antibodies induced by prior transplantation. Human Immunology, 2015, Vol 76(8), pp. 546–552.
Review
For citations:
Usmonov I.M. Impact of pregnancy on allosensitization in women with fifth stage chronic kidney disease. Herald of the medical and social institute of Tajikistan. 2022;(2):66-74. (In Russ.)
Views:
43
Email this article 