Placental antibody transfer in children born to renal transplant recipient women

Abstract

Recent developments in the area of solid organ transplantation have allowed that an increasing number of patients with severe chronic diseases achieve a better quality of life after transplantation. Many women can even regain fertility and get pregnant. However, that is a high-risk pregnancy, where the fetus is conceived and develops exposed to immunosuppressive drugs that the woman cannot stop taking during pregnancy. Due to the effect of immunosuppressive drugs, many patients might not have serum antibody levels comparable to those of healthy women. Also, the high rate of premature births found among children born to renal transplant recipients might reduce placental antibody transfer to the fetus. Of note, present recommendations also preclude breastfeeding for those neonates. To the best of our knowledge, transplacental immunity conferred to children born to renal transplant recipients has not been studied before. In this project, we intend to study 20 neonates born to renal transplant recipients. They will be assessed at birth and compared with 30 neonates born at term to healthy mothers and with 20 preterm neonates matched by gestational age with premature babies born to renal transplant recipients. Ten mL of maternal peripheral blood, 10 mL of cord blood and samples of placenta and membranes will be collected at delivery from each mother-infant pair. Placental total IgG will be assayed by nephelometry and measles, varicella, tetanus, Haemophilus influenzae type b and Streptococcus pneumoniae antibodies, by enzyme immunoassays. Results from this study will permit evaluate placental antibody transfer from renal transplant recipients to their offspring. In case it is reduced, that might suggest testing clinical interventions to enhance immunity from those children at birth and during their first months of life.