Journal article
Impact of donor ABH-secretor status in ABO-mismatched living donor kidney transplantation.
- Drexler B Department of Haematology, University Hospital Basel, Basel. drexlerb@uhbs.ch.
- Holbro A Department of Haematology, University Hospital Basel, Basel.
- Sigle J Blood Transfusion Centre, Swiss Red Cross, Aarau, Switzerland.
- Gassner C Blood Transfusion Service, Swiss Red Cross, Zurich, Switzerland.
- Frey BM Blood Transfusion Service, Swiss Red Cross, Zurich, Switzerland.
- Schaub S Clinic for Transplant Immunology and Nephrology.
- Amico P Clinic for Transplant Immunology and Nephrology.
- Plattner A Department of Haematology, University Hospital Basel, Basel.
- Infanti L Department of Haematology, University Hospital Basel, Basel.
- Menter T Institute for Pathology, University Hospital Basel, Basel, Switzerland.
- Mihatsch MJ Institute for Pathology, University Hospital Basel, Basel, Switzerland.
- Stern M Immunotherapy Laboratory, Department of Biomedicine, University Hospital Basel, Basel, Switzerland.
- Buser A Department of Haematology, University Hospital Basel, Basel.
- Dickenmann M Clinic for Transplant Immunology and Nephrology.
- 2016-07-12
Published in:
- Transfusion. - 2016
ABO Blood-Group System
Adult
Blood Group Incompatibility
Female
Graft Rejection
Humans
Kidney Transplantation
Living Donors
Male
Middle Aged
Retrospective Studies
English
BACKGROUND
The ABO blood group is a major determinant in living donor kidney transplantation since AB antigens are expressed on renal tissue. Little attention has been directed to the ABH-secretor status of the donor kidney. As renal tissue is capable of secreting soluble ABH antigens in secretors, we examined the influence of the ABH-secretor status of kidney donors on outcome in ABO-mismatched living donor kidney transplantation.
STUDY DESIGN AND METHODS
We retrospectively analyzed all patients who underwent ABO-mismatched kidney transplantation at the University Hospital Basel from September 2005 to October 2013. The ABH-secretor status was determined in all donors by molecular genetic analysis.
RESULTS
Of all 55 patients who received transplants, we excluded all patients with donor-specific antibodies (n = 4). Forty-one donors were secretors (78%) and 11 were nonsecretors (22%). Recipients of ABH-secretor donor organs showed a significantly higher glomerular filtration rate throughout the first 6 months posttransplant, whereas no significant influence on posttransplant anti-A/B titers was found. Regression analysis revealed a significant impact on humoral rejection, whereas not on vascular or interstitial rejection in protocol kidney biopsies.
CONCLUSION
The donor ABH-secretor status may have an influence on early posttransplant renal function in patients undergoing ABO-mismatched living donor kidney transplantation. Further prospective studies with long-term follow-up are needed to elucidate involved pathomechanisms.
The ABO blood group is a major determinant in living donor kidney transplantation since AB antigens are expressed on renal tissue. Little attention has been directed to the ABH-secretor status of the donor kidney. As renal tissue is capable of secreting soluble ABH antigens in secretors, we examined the influence of the ABH-secretor status of kidney donors on outcome in ABO-mismatched living donor kidney transplantation.
STUDY DESIGN AND METHODS
We retrospectively analyzed all patients who underwent ABO-mismatched kidney transplantation at the University Hospital Basel from September 2005 to October 2013. The ABH-secretor status was determined in all donors by molecular genetic analysis.
RESULTS
Of all 55 patients who received transplants, we excluded all patients with donor-specific antibodies (n = 4). Forty-one donors were secretors (78%) and 11 were nonsecretors (22%). Recipients of ABH-secretor donor organs showed a significantly higher glomerular filtration rate throughout the first 6 months posttransplant, whereas no significant influence on posttransplant anti-A/B titers was found. Regression analysis revealed a significant impact on humoral rejection, whereas not on vascular or interstitial rejection in protocol kidney biopsies.
CONCLUSION
The donor ABH-secretor status may have an influence on early posttransplant renal function in patients undergoing ABO-mismatched living donor kidney transplantation. Further prospective studies with long-term follow-up are needed to elucidate involved pathomechanisms.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1111/trf.13711
- PMID 27397630
- Persistent URL
- https://sonar.ch/global/documents/53474
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