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Am J Clin Pathol. 2016 Aug;146(2):268-71. doi: 10.1093/ajcp/aqw101.

Successful ABO-Incompatible Renal Transplantation:  Blood Group A1B Donor Into A2B Recipient With Anti-A1 Isoagglutinins.

Author information

1
From the Departments of Pathology efadeyi@wakehealth.edu.
2
Surgery, Wake Forest University School of Medicine, Winston-Salem, NC.
3
From the Departments of Pathology.

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.

KEYWORDS:

ABO incompatible; Antibody-mediated rejection; HLA mismatch; Immunology; Renal transplant; Special topics; Transfusion medicine

PMID:
27473744
DOI:
10.1093/ajcp/aqw101
[Indexed for MEDLINE]

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