title: Postoperative rebound of antiblood type antibodies and antibody-mediated rejection after ABO-incompatible living-related kidney transplantation.
abstract: The purpose of this study is to examine whether postoperative antiblood type antibody rebound is attributed to kidney allograft rejection in ABO blood type-incompatible (ABO-I) living-related kidney transplantation (KTx). A total of 191 ABO-I recipients who received ABO-I living-related KTx between 2001 and 2013 were divided into two groups: Group 1 consisted of low rebound [(≦1:32), N = 170] and Group 2 consisted of high rebound [(≧1:64), N = 21], according to the levels of the rebounded antiblood type antibodies within 1 year after transplantation. No prophylactic treatment for rejection was administered for elevated antiblood type antibodies, regardless of the levels of the rebounded antibodies. Within 1 year after transplantation, T-cell-mediated rejection was observed in 13 of 170 recipients (13/170, 8%) in Group 1 and in 2 of 21 recipients (2/21, 10%) in Group 2 (Groups 1 vs. 2, P = 0.432). Antibody-mediated rejection was observed in 15 of 170 recipients (15/170, 9%) and 2 of 21 recipients (2/21, 10%) in Groups 1 and 2, respectively (P = 0.898). In this study, we found no correlation between the postoperative antiblood type antibody rebound and the incidence of acute rejection. We concluded that no treatment is necessary for rebounded antiblood type antibodies.
authors.affiliation: Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishida
authors.forename: Tsunenori
authors.initials: T
authors.lastname: Kondo
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Shimizu
authors.forename: Taiji
authors.initials: T
authors.lastname: Nozaki
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000906:Antibodies / Q000276:immunology*; D001787:Blood Group Incompatibility / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies
chemical_list: D000017:ABO Blood-Group System; D000906:Antibodies
keywords: ABO-incompatible kidney transplantation; B cell-targeting protocol; acute antibody-mediated rejection; antiblood type antibody; chronic antibody-mediated rejection; desensitization protocol; graft loss; graft survival rate; renal transplantation; rituximab; titres