title: Impact of the baseline anti-A/B antibody titer on the clinical outcome in ABO-incompatible kidney transplantation.
abstract: OBJECTIVE
  We investigated the impact of the baseline anti-A/B antibody titer on the clinical outcome in ABO-incompatible kidney transplantation (IKT).
  
  
  METHODS
  We included 183 patients who had undergone KT (40 ABO IKT and 143 ABO-compatible KT). Eight patients with a baseline titer of ≥1:512 were assigned to the high-titer group and 32 patients with a baseline titer of ≤1:256 were assigned to the low-titer group. Patients who underwent ABO-compatible KT were used as the control group. We compared the clinical outcomes of the three groups.
  
  
  RESULTS
  Before transplantation, the high-titer group displayed more frequent antibody rebound, as shown in a lower titer reduction rate, and more difficulty reaching the target titer (1:16) than the low-titer group. During the postoperative period and out-clinic follow-up, antibody rebound was more frequent, and the rate of acute rejection and infection were significantly higher and allograft function was lower in the high-titer group than in the low-titer and control groups. Multivariate analysis showed that high baseline antibody titer was an independent risk factor for acute rejection.
  
  
  CONCLUSIONS
  ABO IKT in the high-titer group (baseline titer ≥1:512) required greater caution compared to the low-titer group because of the higher tendency of antibody rebound and the risk for acute rejection.
authors.affiliation: Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
authors.forename: Jeong Uk
authors.initials: JU
authors.lastname: Lim
authors.forename: Yaeni
authors.initials: Y
authors.lastname: Kim
authors.forename: Ji-Il
authors.initials: JI
authors.lastname: Kim
authors.forename: In Sung
authors.initials: IS
authors.lastname: Moon
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.forename: Cheol Whee
authors.initials: CW
authors.lastname: Park
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
mesh_terms: D000017:ABO Blood-Group System / Q000097:blood / Q000276:immunology*; D000328:Adult; D001787:Blood Group Incompatibility / Q000097:blood / Q000276:immunology* / Q000401:mortality; D015984:Causality; D005260:Female; D006084:Graft Rejection / Q000097:blood* / Q000401:mortality; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D015995:Prevalence; D011379:Prognosis; D056910:Republic of Korea; D012307:Risk Factors; D015996:Survival Rate; D014181:Transplantation Immunology / Q000276:immunology*
chemical_list: D000017:ABO Blood-Group System; D007518:Isoantibodies