title: High anti-A titres may not preclude ABO-incompatible renal transplantation: an autoantibody could be the culprit.
abstract: ABO-incompatible live donor renal transplantation is a growing field. To avoid hyperacute rejection, pre-operative ABO antibody titres should be < 8. There are a number of therapeutic measures used to reduce these titres if they are high. This case report describes a patient initially found to have an extremely high anti-A IgG titre (512). The high titre results were concomitant with a positive atypical antibody screen, which showed no specificity on identification. A strategy to assess true titre levels and remove sub-clinical autoantibodies was devised, leading to successful transplantation.
authors.affiliation: Renal, Urology and Transplantation Directorate, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Barnett
authors.forename: Anne
authors.initials: A
authors.lastname: Nightingale
authors.forename: Tim
authors.initials: T
authors.lastname: Maggs
authors.forename: Malcolm
authors.initials: M
authors.lastname: Needs
authors.forename: Eleanor
authors.initials: E
authors.lastname: Williams
authors.forename: David
authors.initials: D
authors.lastname: Curran
authors.forename: Nizam
authors.initials: N
authors.lastname: Mamode
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D001787:Blood Group Incompatibility / Q000276:immunology*; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D016030:Kidney Transplantation / Q000276:immunology*; D008875:Middle Aged
chemical_list: D000017:ABO Blood-Group System; D001323:Autoantibodies; D007075:Immunoglobulin M