Offspring-to-mother and husband-to-wife renal transplantation: a single-center experience.
BACKGROUND
It has been demonstrated that graft survival rates of offspring-to-mother and husband-to-wife renal transplants are equivalent to those of other living donors. Although the vast majority of these transplants proceed without incident, hyperacute rejection can result from an anamnestic reaction subsequent to the in utero exposure of the mother to human leukocyte antigen (HLA) of the fetus with sensitization developing during the pregnancy.


METHODS
Among 1350 renal transplants performed at our center, 12 corresponded to offspring-to-mother (G1) and 9 were husband-to-wife transplantations (G2). All recipients were multiparous (2 to 5 children). We compared these patients with other multiparous women (n = 150) who received grafts from living unrelated donors (G3).


RESULTS
Two subjects in G1 (16.6%), two in G2 (22.2%), and none in G3 developed hyperacute rejection, which led to graft loss. One, 3-, and 5-year patient and graft survival rates were different between the remaining patients.


CONCLUSIONS
Our limited experience suggested that, for some women, pregnancy is in fact a sensitizing event. A pretransplantation cross-match testing negative result was by no means an absolute guarantee that an adverse anamnestic immunological event would not occur.
Ghafari
A
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Nephrology Department, Emam Hospital, Urmia University of Medical Sciences, Urmia, Iran. ghaf_ali@yahoo.com
D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family; D010287:Parent-Child Relations; D012189:Retrospective Studies; D018454:Spouses; D016019:Survival Analysis; D016896:Treatment Outcome