Blood group O recipients associated with early graft deterioration in living ABO-incompatible kidney transplantation.
BACKGROUND
Blood group O individuals are known to have larger amounts of anti-ABO blood group (anti-A/B) IgG antibodies than A or B individuals. Therefore, in ABO-incompatible (ABOI) kidney transplantation (KTX), it is expected that blood group O recipients are more likely to suffer graft damage, because anti-A/B IgG antibodies are believed to be responsible for worse graft outcomes.


METHODS
This study assessed the graft outcomes between blood group O and non-O recipients in ABOI-KTX. A total of 164 consecutive recipients who underwent ABOI-KTX between 1990 and 2007 under three different immunosuppressive protocols were enrolled in this study. The study population was divided into two groups: (i) recipients with blood group O (n=87) and (ii) recipients with blood group A or B (non-O) (n=77).


RESULTS
High anti-A/B IgG titers were predominant in the O group (P<0.001), whereas no significant difference was observed in the IgM titers. The overall graft survival rate did not differ between the two groups; however, the 6-month graft survival rate was significantly lower in the O group (86% vs. 97%, P=0.011). Among 14 recipients who suffered graft loss within 6 months after transplantation, 12 (86%) were O recipients. The cumulative incidence of acute antibody-mediated rejection was significantly higher in the O group (60 days, 31 vs. 14%, P=0.013).


CONCLUSIONS
Our results may indicate that being a blood group O recipient is at great risk for experiencing early allograft deterioration, probably caused by anti-A/B IgG antibodies in ABOI-KTX.
Toki
Daisuke
D
Department of Urology, Tokyo Women's Medical University, Tokyo, Japan. Tokidsk@gmail.com
Ishida
Hideki
H
Horita
Shigeru
S
Yamaguchi
Yutaka
Y
Tanabe
Kazunari
K
D000017:ABO Blood-Group System / Q000276:immunology*; D000208:Acute Disease; D000328:Adult; D001787:Blood Group Incompatibility / Q000276:immunology* / Q000628:therapy; D001803:Blood Transfusion; D015935:Complement C4b / Q000032:analysis; D003429:Cross Reactions; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology / Q000628:therapy; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D010951:Plasma Exchange; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000276:immunology; D016896:Treatment Outcome; D055815:Young Adult
D000017:ABO Blood-Group System; D006680:HLA Antigens; D007074:Immunoglobulin G; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d