Blood group A and B antigen expression in human kidneys correlated to A1/A2/B, Lewis, and secretor status.
BACKGROUND
In the revived interest in crossing ABO barriers in organ transplantation renal A/B antigen expression has been correlated with donor ABO, Lewis, and secretor subtype to predict antigen expression.


METHODS
A/B antigen expression was explored by immunohistochemistry in LD renal biopsies. Donor A1/A2/B, Lewis, and secretor status were determined by serology and polymerase chain reaction.


RESULTS
In the renal vascular bed, three distinct A antigen expression patterns with a major, minor, and minimal staining distribution, and intensity (designated as types 3+, 1+ and (+) respectively) were identified. Type 3+ had a strong A antigen expression in the endothelium of arteries, glomerular/peritubular capillaries and veins. The type 1+ showed an overall weaker antigen expression, whereas type (+) had faint staining of peritubular capillaries only. In all cases, distal tubular epithelium was focally stained, whereas proximal tubules were negative. Type 3+ were all from blood group A1 subtype individuals while A2 cases expressed either a 1+ or (+) pattern. The secretor gene did not appear to influence renal A antigen expression. All B kidneys examined showed a B antigen pattern slightly weaker but otherwise similar to A type 3+.


CONCLUSIONS
Renal vascular A antigen expression correlates to donor A1/A2 subtypes, whereas B individuals show one singular antigen pattern. From antigen perspective, A1 and B donors are a "major" and A2 individuals a "minor" antigen challenge in ABO-incompatible renal transplantation.
Breimer
Michael E
ME
Department of Surgery, Göteborg University, Sahlgrenska University Hospital, Göteborg, Sweden. michael.breimer@clinchem.gu.se
Mölne
Johan
J
Nordén
Gunnela
G
Rydberg
Lennart
L
Thiel
Gilbert
G
Svalander
Christian T
CT
D000017:ABO Blood-Group System / Q000032:analysis* / Q000276:immunology; D001787:Blood Group Incompatibility; D006801:Humans; D007150:Immunohistochemistry; D007668:Kidney / Q000276:immunology*; D016030:Kidney Transplantation / Q000276:immunology*; D007983:Lewis Blood Group Antigens / Q000032:analysis*; D014019:Tissue Donors
D000017:ABO Blood-Group System; D007983:Lewis Blood Group Antigens