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Outcome of Husband-to-Wife Kidney Transplantation With Mutual Children: Single Center Experience Using T Cell-Depleting Induction and Review of the Literature
- Source :
- Frontiers in Medicine, Vol 8 (2021), Frontiers in Medicine
- Publication Year :
- 2021
- Publisher :
- Frontiers Media SA, 2021.
-
Abstract
- Few data on husband-to-wife transplantations with mutual children (H2W) exist in the current era. We investigated the outcome of H2W transplantations (n = 25) treated with T cell-depleting induction compared to women with prior pregnancies also receiving their first HLA-mismatched kidney transplant, but from a different donor source: (i) other living donor (n = 52) and (ii) deceased donor (n = 120). Seventy-four percent of the women had ≥2 pregnancies; median follow-up time was 5 years. Death-censored allograft survival was significantly lower in the H2W group compared to the other two groups (p = 0.03). Three of four graft losses in the H2W group were due to rejection. 5-year patient survival in the H2W group was high and similar compared to the other living donor group (100 vs. 98%; p = 0.28). The incidence of (sub)clinical antibody-mediated rejection was higher in the H2W group (36 vs. 20 vs. 18%) (p = 0.10). The frequency of infections was similar among the three groups. No immunological parameter was predictive for rejection or graft loss in H2W transplantations. In conclusion, H2W transplantation is a valuable option, but associated with a higher risk for allograft loss due to rejection despite T cell-depleting induction. Further research is required for better risk prediction on an individual patient level.
- Subjects :
- medicine.medical_specialty
Medicine (General)
T cell
030232 urology & nephrology
kidney transplantation
030230 surgery
Single Center
Living donor
03 medical and health sciences
0302 clinical medicine
R5-920
husband-to-wife transplantation
Internal medicine
Allograft survival
medicine
Kidney transplantation
Original Research
business.industry
allograft rejection
Incidence (epidemiology)
Patient survival
pregnancy-induced sensitization
General Medicine
medicine.disease
infection
Transplantation
medicine.anatomical_structure
Medicine
business
Subjects
Details
- Language :
- English
- ISSN :
- 2296858X
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Frontiers in Medicine
- Accession number :
- edsair.doi.dedup.....1713851ab6d0afbab09fbc042a5e0a2b
- Full Text :
- https://doi.org/10.3389/fmed.2021.724851