Red blood cell and leukocyte alloimmunization in patients awaiting kidney transplantation

Abstract

Objective To determine the rates of red blood cell and leukocyte alloimmunization in patients with chronic kidney disease awaiting kidney transplantation. Methods In this cross-sectional and prospective study, the serum of 393 chronic kidney disease patients on a transplant waiting list in Ceará, Northeastern Brazil were tested for red cell and leukocyte antibodies. In addition, demographic, clinical and laboratory data were collected. Results The average age in the sample of 393 patients was 34.1 ± 14 years. Slightly more than half (208; 52.9%) were male. The average numbers of transfusions and gestations were 3.1 ± 3.3 and 1.6 ± 6, respectively. One third (33.6%) were alloimmunized: 78% with leukocyte antibodies, 9.1% with red cell antibodies and 12.9% with both. Red cell antibodies were detected in 29 cases (7.4%), 17 of whom were women, who had received more transfusions than the males (p-value < 0.0001). The most frequently detected red cell antibodies belonged to the Rh (24.1%) and Kell (13.8%) blood group systems. Leukocyte antibodies were detected in 30.5% of cases, 83 of whom were women, who had received more transfusions than the males (p-value < 0.0001) and were more reactive to panel reactive antibodies (p-value < 0.0001). The mean alloreactivity to panel reactive antibodies was 47.7 ± 31.2%. Conclusion Chronic kidney disease patients on the transplant waiting list in Ceará, Brazil, display high rates of red cell (7.4%) and leukocyte (30.5%) alloimmunization. In this sample, alloimmunization was significantly associated with the number of transfusions and gender.

Red blood cell alloimmunization in multi-transfused patients with chronic kidney disease in Port Harcourt, South-South Nigeria

“…In our study, the rate of alloimmunization was not significantly influenced by sex which is contrary to what was reported by Babiker et al,27 Silvia et al28 and Zaman et al29 who found a higher prevalence in women, but similar to the findings of Shukla et al30 We also observed that all the alloimmunised patients developed multiple antibodies contrary to the findings of Skulla30. This may be attributed to genetic differences, and lack of routine pretransfusion antibody screening test in this environment which increases the tendency to develop an additional alloantibody after subsequent transfusions.…”

Evaluation of the Humoral Immune Response to Human Leukocyte Antigens in Brazilian Renal Transplant Candidates

“…In the present study, the percentage of sensitized patients was higher than that found by Silva et al [17]. One possible explanation could lie in the different methodologies used to determine the PRA.…”

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“…Several studies have reported high rates of leukocyte alloimmunization in renal transplant candidates. 18,19 Similarly to that reported by Hyun et al, 6 we found that the percentage of sensitized ESRD patients was 40.6%. As expected, sensitizing events were associated with higher prevalence of anti-HLA antibodies compared with patients without sensitizing events.…”