Article
Medicine, General & Internal
Hyeyeon Cho, Jinyoung Bae, Hyun-Kyu Yoon, Ho-Jin Lee, Seong-Mi Yang, Suk Hyung Choe, Chul-Woo Jung, Kyung-Suk Suh, Won Ho Kim
Summary: High preoperative and postoperative peak Ig M isoagglutinin titers were significantly associated with the risk of acute kidney injury (AKI) in ABO-incompatible liver transplantation. However, no significant differences were observed in other clinical outcomes based on isoagglutinin titers. This suggests that high isoagglutinin titers may serve as a warning sign for AKI risk after liver transplantation.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Immunology
Federica Maritati, Claudia Bini, Vania Cuna, Francesco Tondolo, Sarah Lerario, Valeria Grandinetti, Marco Busutti, Valeria Corradetti, Gaetano La Manna, Giorgia Comai
Summary: For a long time, ABO incompatible living donor kidney transplantation has been considered contraindicated. However, with the increasing demand for kidney transplantation, methods to expand the donor pool have become important. Desensitization strategies for ABOi transplantation have been developed and the outcome has improved. Although concerns exist, recent studies show no difference in graft and patient survival between ABOi and ABO compatible kidney transplant. Further improvement in desensitization strategies is needed to minimize risks. This review discusses immune mechanisms, tolerance pathogenesis, desensitization regimens, and the future perspectives in ABOi kidney transplant.
JOURNAL OF INFLAMMATION RESEARCH
(2022)
Review
Immunology
Hiroto Egawa, Hideki Ohdan, Kazuhide Saito
Summary: By 2014, strategies to prevent antibody-mediated rejection (AMR) after ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) were established in Japan and expanded primarily to Asia. The best option currently is a desensitization protocol including rituximab, plasma pheresis, tacrolimus, and mycophenolate mofetil. Strategies are needed to distinguish patients at high risk of AMR from those at low risk and to adjust immunosuppression to prevent both AMR and infection.
Article
Immunology
Kevin Verhoeff, Nerea Cuesta-Gomez, Patrick Albers, Rena Pawlick, Braulio A. Marfil-Garza, Ila Jasra, Nidheesh Dadheech, Doug O'Gorman, Tatsuya Kin, Anne Halpin, Lori J. West, A. M. James Shapiro
Summary: This study evaluated the expression of ABH glycans in human pancreas, isolated islets, and hESC-derived islets. The study found that endocrine and ductal cells in the pancreas do not express ABH antigens, while acinar tissues strongly express them. Clinical pancreatic islet transplantation should remain ABO-matched due to the presence of acinar tissue expressing ABH glycans in islet preparations.
Article
Surgery
Masayuki Tasaki, Hiroaki Tateno, Takashi Sato, Azusa Tomioka, Hiroyuki Kaji, Hisashi Narimatsu, Kazuhide Saito, Yuki Nakagawa, Toshinari Aoki, Masami Kamimura, Takashi Ushiki, Manabu Okada, Yuko Miwa, Kiyohiko Hotta, Yutaka Yoshida, Kota Takahashi, Yoshihiko Tomita
Summary: In this study, a new method to measure antibody titer using a microarray of recombinant CD31 linked to ABO antigens was developed. The results showed that this method had higher sensitivity and specificity in predicting antibody-mediated rejection in kidney transplantation compared to traditional isohemagglutinin assays.
TRANSPLANT INTERNATIONAL
(2022)
Review
Gastroenterology & Hepatology
Cheng-Zuo Han, Qiang Wei, Meng-Fan Yang, Li Zhuang, Xiao Xu
Summary: This study highlights the importance of therapeutic plasma exchange (TPE) in expanding the donor liver pool and preventing antibody-mediated rejection (AMR) after ABO-incompatible liver transplantation (ABO-I LT). However, the application of TPE varies among different centers and standardized treatment procedures are lacking.
HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL
(2022)
Article
Urology & Nephrology
Masayuki Tasaki, Hiroaki Tateno, Takashi Sato, Hisashi Narimatsu, Kazuhide Saito, Yuki Nakagawa, Toshinari Aoki, Masami Kamimura, Takashi Ushiki, Kota Takahashi, Yoshihiko Tomita
Summary: The study investigated the reactivity of anti-ABO antibodies detected after ABO-incompatible kidney transplantation with stable graft function to the renal graft endothelial cells, and found that the antibody reactivity was low.
CLINICAL AND EXPERIMENTAL NEPHROLOGY
(2023)
Article
Urology & Nephrology
Kazunobu Shinoda, Yoji Hyodo, Hideyo Oguchi, Tetuo Mikami, Kenta Nishikawa, Kei Sakurabayashi, Takashi Yonekura, Yujiro Aoki, Yoshihiro Itabashi, Masaki Muramatsu, Takeshi Kawamura, Ken Sakai, Seiichiro Shishido
Summary: This study aimed to investigate whether pretransplant antibody removal is necessary for ABO-incompatible kidney transplant recipients with low isoagglutinin titers. The results suggest that not only B-cell depletion using RTX but also pretransplant antibody removal is recommended for patients with low titers. In addition, a new diagnostic tool is needed for accurate risk stratification.
INTERNATIONAL JOURNAL OF UROLOGY
(2022)
Article
Hematology
Ako Hanaoka, Toshihide Naganuma, Daijiro Kabata, Daichi Morii, Yoshiaki Takemoto, Junji Uchida, Ayumi Shintani
Summary: Tandem HD and SePE therapy showed higher internal pressures and larger changes in TMP and AP compared to SePE monotherapy. Group T had a more significant decrease in IgG isoagglutinin levels compared to Group S. No cases of antibody-mediated rejection occurred after transplantation.
BLOOD PURIFICATION
(2021)
Article
Surgery
Andrew Bentall, Mylvaganam Jeyakanthan, Manjit Braitch, Christopher W. Cairo, Todd L. Lowary, Stephanie Maier, Anne Halpin, Bruce Motyka, Lu Zou, Lori J. West, Simon Ball
Summary: ABO-incompatible kidney transplantations require preemptive antibody reduction. A study on ABO-O recipients of ABO-A kidneys revealed that ABO-A trisaccharide is sufficient for IgM binding to all A-subtypes, with A-II being the major, but not the sole, antigen relevant to treatment and immune modulation. IgG binding to different A-subtypes exhibited varying degrees of specificity, with A-II showing the most reduced antibody levels posttransplantation.
AMERICAN JOURNAL OF TRANSPLANTATION
(2021)
Article
Medicine, General & Internal
Saifu Yin, Qiling Tan, Youmin Yang, Fan Zhang, Turun Song, Yu Fan, Zhongli Huang, Tao Lin, Xianding Wang
Summary: This study explored the efficacy and safety of an individualized preconditioning regimen for ABO-incompatible (ABOi) kidney transplantation. The results showed that the regimen achieved comparable graft and patient survival rates as ABO-compatible (ABOc) kidney transplantation, and effectively prevented acute rejection (AR). However, monitoring antibody titer rebound is necessary.
CHINESE MEDICAL JOURNAL
(2022)
Article
Medicine, General & Internal
Daqiang Zhao, Lan Zhu, Shengyuan Zhang, Zhiliang Guo, Lu Wang, Tianhui Pan, Rula Sa, Zhishui Chen, Jipin Jiang, Gang Chen
Summary: This study reports the first ABO-incompatible deceased donor kidney transplantation (ABOi DDKT) in an infant. The recipient was diagnosed with a Wilms tumor gene 1 (WT1) mutation and had received peritoneal dialysis before the transplant. No antibody removal treatment was performed, and the recipient had good graft function and normal development at 11 months post-transplant. ABOi DDKT without antibody removal treatment is a feasible option for kidney transplantation in small infants.
FRONTIERS IN MEDICINE
(2022)
Article
Immunology
Fan Zhang, Saifu Yin, Yu Fan, Turun Song, Zhongli Huang, Jiayu Liang, Jiapei Wu, Youmin Yang, Tao Lin, Xianding Wang
Summary: This study found that the secretor status of both donors and recipients may have an impact on the outcomes of ABO incompatibility kidney transplantation. Recipients with weak secretor status may have better post-transplant renal function, while recipients from secretor donors had a lower incidence of graft rejection in the first year after transplantation.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Immunology
Junxiang Wang, Hao Feng, Chi Zhang, Shan Zhong, Lu Wang, Lan Zhu, Song Chen, Gang Chen
Summary: Establishment of a hyperacute rejection (HAR) model of ABO-incompatible kidney transplantation (ABOi-KTx) in nonhuman primates through pre-sensitization with A-KLH in blood group B cynomolgus monkeys resulted in increased anti-A antibody levels and successful induction of HAR in all monkeys post-transplantation. Targeting renal tubular epithelial cells (RTECs) was found to be more effective than red blood cells (RBCs) for detecting blood group antibodies by flow cytometry. This model will be valuable for further research on rejection, accommodation, and clinical intervention in ABOi-KTx.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Surgery
Deok Gie Kim, Juhan Lee, Myoung Soo Kim, Oh Jung Kwon, Cheol Woong Jung, Kang Wook Lee, Jaeseok Yang, Curie Ahn, Kyu Ha Huh
Summary: In older patients, ABOi LDKT is comparable to ABOc LDKT and superior to DDKT in terms of patient survival.
TRANSPLANT INTERNATIONAL
(2021)
Editorial Material
Urology & Nephrology
I. Kagan, M. L. McDonald, H. A. Gritsch, J. M. Yabu
KIDNEY INTERNATIONAL
(2019)
Article
Multidisciplinary Sciences
Timothy S. Chang, Yi Ding, Malika K. Freund, Ruth Johnson, Tommer Schwarz, Julie M. Yabu, Chad Hazlett, Jeffrey N. Chiang, David A. Wulf, Daniel H. Geschwind, Manish J. Butte, Bogdan Pasaniuc
Summary: This study investigated COVID-19 risk factors in Hispanic/Latinx individuals using individual-level, electronic health records in a Los Angeles health system. Risk factors identified in Hispanic/Latinx were similar to those in non-Hispanic/Latinx whites, suggesting the importance of studying COVID-19 risk factors for Hispanic/Latinx individuals to guide equitable government policies and identify at-risk populations.
Article
Urology & Nephrology
Boonphiphop Boonpheng, Jonathan E. Zuckerman, Gerald S. Lipshutz, Gabriel M. Danovitch, Angela Phelps, Michele Pena, Julie M. Yabu
Summary: This case presents a patient who developed mesangial sclerosis resembling diabetic nephropathy after a successful simultaneous pancreas-kidney transplantation, despite good glucose control and excellent pancreatic allograft function.
