Effects of Neutralization by Soluble ABH Antigens Produced by Transplanted Kidneys From ABO-Incompatible Secretor Donors.
10.3343/alm.2017.37.3.254
- Author:
Jieun KIM
1
;
Sinyoung KIM
;
In Sik HWANG
;
Jong Rak CHOI
;
Jae Geun LEE
;
Yu Seun KIM
;
Myoung Soo KIM
;
Hyun Ok KIM
Author Information
1. Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea. hyunok1019@yuhs.ac
- Publication Type:Original Article
- Keywords:
Blood group incompatibility;
Kidney transplantation;
Blood group antigens;
β-galactoside α-1,2-fucosyltransferase;
Graft survival
- MeSH:
Absorption;
Allografts;
Antibodies;
Blood Group Antigens;
Blood Group Incompatibility;
Genotype;
Graft Survival;
Humans;
Immunoglobulin G;
Immunoglobulin M;
Kidney Transplantation;
Kidney*;
Tissue Donors*;
Transplants
- From:Annals of Laboratory Medicine
2017;37(3):254-260
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Grafts survive despite blood group antigens on the transplant being continuously exposed to antibodies in the blood of recipients in ABO-incompatible kidney transplantation (ABOi KT), owing to the mechanism of accommodation. We analyzed the immunodynamics of soluble ABH antigens in allografts from secretor donors and the influence of such immunodynamics on accommodation and subsequent graft survival in ABOi KT. METHODS: The genotype of a known human β-galactoside α-1,2-fucosyltransferase gene (FUT2), which determines soluble ABH antigen secretor status, was established in 32 donors for ABOi KT at the Severance Hospital, from June 2010 to July 2015. Clinical outcomes of recipients, such as anti-A/B antibody titer change, renal function, and graft survival, were evaluated. RESULTS: Twenty-five donors were secretors (78.1%), and seven were nonsecretors (21.9%). The frequency of anti-A/B IgG or IgM antibody titer elevation or reduction post-transplantation was not significantly related to donor secretor status. However, IgM titer was rapidly reduced in recipients transplanted from nonsecretor donors (P=0.01), which could be explained by the lack of absorption effect of soluble antigens, enhancing the binding of antibodies to antigens in the allografts. Interestingly, soluble ABH antigens did not affect rejection-free graft survival, which may be due to the nature of β-galactoside α-1,2-fucosyltransferase. CONCLUSIONS: Soluble ABH antigens produced by transplanted kidneys from secretor donors played a role in inducing accommodation within three months of KT through neutralization; however, major graft outcomes were not affected.
