Cesarean Section Is a Risk Factor That Prevents Organ Transplantation by Increasing the Development of Anti-HLA Antibodies in Women

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2024-10-22 DOI:10.1111/ctr.70005

Gökhan Akyüz, Hasan Doğan

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Abstract

Background

In this study, prenatal and postnatal blood samples were taken from pregnant women who had 35 or more gestational weeks and had not developed anti-HLA positivity yet. The aim of this study was to evaluate the factors that may be effective in the development of panel reactive antibody (PRA) positivity during pregnancy.

Methods

PRA testing was studied by taking the blood of 86 pregnant women 1 month before birth. Blood was taken again 1 month after birth from these women with prenatal PRA negative and it was checked whether PRA positivity developed. As a control group, 40 women without pregnancy were selected for the study.

Results

Of the 86 pregnant, 42 (48.8%) had cesarean sections, 44 (51.2%) had normal births, and PRA positivity developed in 14 (32.5%) of cesarean deliveries and three (8.0%) of normal births. In the control group, there were three (7.5%) PRA positivity. A statistically significant difference was found between cesarean delivery, normal delivery, and control group. Moreover, when compared with the control group, it was found statistically significant that all deliveries increased the development of HLA Class II antibodies.

Discussion

Cesarean delivery was associated with increased PRA positivity compared to normal birth. The new information presented in this study will pave the way for further research and enable healthcare professionals to consider both the individual's potential future need for organ transplantation and the positive impact on public health and more effective management of healthcare costs when making decisions regarding cesarean section.

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剖腹产是通过增加女性体内抗 HLA 抗体的产生来阻止器官移植的一个风险因素。

研究背景在这项研究中，产前和产后血液样本取自妊娠周数为 35 周或 35 周以上且尚未出现抗-HLA 阳性的孕妇。本研究的目的是评估在妊娠期间可能有效导致面板反应性抗体（PRA）阳性的因素：方法：在分娩前 1 个月抽取 86 名孕妇的血液进行 PRA 检测。产前 PRA 阴性的孕妇在产后 1 个月再次抽血，检查是否出现 PRA 阳性。研究还选取了 40 名未怀孕的妇女作为对照组：在 86 名孕妇中，42 人（48.8%）剖宫产，44 人（51.2%）顺产，其中 14 人（32.5%）剖宫产，3 人（8.0%）顺产，PRA 阳性。对照组中有 3 例（7.5%）PRA 阳性。在统计学上，剖宫产组、顺产组和对照组之间存在明显差异。此外，与对照组相比，所有分娩均增加了 HLA II 类抗体的产生，这在统计学上有显著意义：讨论：与顺产相比，剖腹产与 PRA 阳性增加有关。本研究提供的新信息将为进一步的研究铺平道路，并使医护人员在做出剖腹产决定时，既能考虑到个人未来对器官移植的潜在需求，又能考虑到对公共卫生的积极影响以及更有效的医疗成本管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.