Successful ABO-Incompatible Renal Transplantation:  Blood Group A1B Donor Into A2B Recipient With Anti-A1 Isoagglutinins. Issue 2 (27th July 2016)

• Record Type: Journal Article
• Authors: Fadeyi, Emmanuel A.; Stratta, Robert J.; Farney, Alan C.; Pomper, Gregory J.
• Is Part Of: American journal of clinical pathology. Volume 146:Issue 2(2016)
• Page Start: 268
• Page End: 271
• Publication Date: 2016-07-27
• Subjects: ABO incompatible -- HLA mismatch -- Antibody-mediated rejection -- Renal transplant -- Immunology -- Special topics -- Transfusion medicine; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqw101
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract : Objectives: Transplantation of the blood group A2B in a recipient was successfully performed in the setting of receiving a deceased donor kidney from an "incompatible" A1B donor. Methods: The donor and recipient were both typed for ABO blood group, including ABO genotyping. The donor and recipient were tested for ABO, non-ABO, and human leukocyte antigen (HLA) antibodies. The donor and recipient were typed for HLA antigens, including T- and B-flow cytometry crossmatch tests. Results: The recipient's RBCs were negative with A1 lectin, and immunoglobulin G anti-A1 was demonstrated in the recipient's plasma. The donor-recipient pair was a four-antigen HLA mismatch, but final T- and B-flow cytometry crossmatch tests were compatible. The transplant procedure was uneventful; the patient experienced immediate graft function with no episodes of rejection or readmissions more than 2 years later. Conclusions: It may be safe to transplant across the A1/A2 blood group AB mismatch barrier in the setting of low titer anti-A1 isoagglutinins without the need for pretransplant desensitization even if the antibody produced reacts with anti–human globulin.