title: The evaluation of graft irradiation as a method of preventing hemolysis after ABO-mismatched renal transplantation.
abstract: Hemolysis may occur after organ transplantation. In most cases, hemolysis is drug-related, such as to cyclosporin, etc. However, it is important to consider graft-versus-host antibody formation as one of the causes of hemolysis. We evaluated the effect of local graft irradiation as a method of preventing hemolysis arising from ABO antibody formation after ABO-mismatched renal transplantations. The participants in this study were 44 patients who had undergone ABO-mismatched renal transplantation. Of these patients, 23 were subjected to postoperative local irradiation, and 21 were not. We examined the characteristics of anti-blood-type antibodies, and we also compared the frequency of the development of antibody formation and hemolysis development between the groups. The development rates of anti-ABO-antibody formation and hemolysis were significantly higher in the patients without local irradiation (15/21, 71%; 6/21, 29%) than in those with local irradiation (1/23, 4%; 0/23, 0%). The elevated antibodies mainly belonged to the IgG class, not the IgM class. The hemolysis- and antibody formation observed in the patients originally without postoperative local irradiation was dramatically improved by graft irradiation. Local graft irradiation after ABO-mismatched renal transplantations may be needed to prevent the formation of anti-ABO antibodies and to impede the development of hemolysis.
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku 162-0054, Tokyo, Japan. tgphide@gol.com
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishida
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Tokumoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimmura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Toma
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000917:Antibody Formation / Q000528:radiation effects; D001787:Blood Group Incompatibility / Q000276:immunology*; D005260:Female; D006461:Hemolysis / Q000528:radiation effects*; D006801:Humans; D007074:Immunoglobulin G / Q000096:biosynthesis; D007518:Isoantibodies / Q000096:biosynthesis; D007668:Kidney / Q000528:radiation effects; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male
chemical_list: D000017:ABO Blood-Group System; D007074:Immunoglobulin G; D007518:Isoantibodies