title: Donor- and recipient-derived immunity in ABO incompatible living-related liver transplantation.
abstract: This report describes how donor- and recipient-derived immunity was influenced by immunosuppressive treatment of ABO incompatibility (rituximab and immunoadsorption/plasmaphereses) in the long-term. We present an 8-year course of Hepatitis B virus (HBV) immunity, isohemagglutinins and B cell numbers. Whereas cellular HBV immunity was transferred from the HBV vaccinated donor (blood group A1) to the HBV naïve recipient (blood group 0), humoral HBV specific immune transfer was lacking. Starting at month 17 after transplantation, the recipient was vaccinated six times against HBV. Anti-HBs did not appear until the sixth vaccination at month 44. Immunoadsorption prior to transplantation reduced anti-A1 IgG titers from 256 to 2. Titers after transplantation remained low (⩽64). B cell numbers were below standard values up to month 26, then normalized and exceeded normal values from year 7 to 8 post transplantation. In conclusion, donor-derived B cell immunity was lost but recipient-derived immunity persisted after ABO incompatible transplantation.
authors.affiliation: Institute for Transfusion Medicine, University Hospital Essen, 45122 Essen, Germany; Institute of Virology, University Hospital Essen, 45122 Essen, Germany; Department of Clinical Chemistry, University Hospital Essen, 45122 Essen, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schumann
authors.affiliation: Institute of Virology, University Hospital Essen, 45122 Essen, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Fiedler
authors.affiliation: Department of Transplant Medicine, University Hospital Münster, 48149 Münster, Germany; St. Josef-Krankenhaus, Department of Internal Medicine, 45257 Essen, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Beckebaum
authors.affiliation: Department of Transplant Medicine, University Hospital Münster, 48149 Münster, Germany; St. Josef-Krankenhaus, Department of Internal Medicine, 45257 Essen, Germany.
authors.forename: Vito R
authors.initials: VR
authors.lastname: Cicinnati
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, 45122 Essen, Germany; Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, 45122 Essen, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Herzer
authors.affiliation: Institute for Transfusion Medicine, University Hospital Essen, 45122 Essen, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Lenz
authors.affiliation: Department of Nephrology, University Hospital Essen, 45122 Essen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Witzke
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, 45122 Essen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.affiliation: Institute of Virology, University Hospital Essen, 45122 Essen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Roggendorf
authors.affiliation: Institute for Transfusion Medicine, University Hospital Essen, 45122 Essen, Germany.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Horn
authors.affiliation: Institute for Transfusion Medicine, University Hospital Essen, 45122 Essen, Germany. Electronic address: monika.lindemann@uk-essen.de.
authors.forename: Monika
authors.initials: M
authors.lastname: Lindemann
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D056704:Adaptive Immunity; D001402:B-Lymphocytes / Q000276:immunology / Q000378:metabolism; D001787:Blood Group Incompatibility / Q000276:immunology*; D005260:Female; D006510:Hepatitis B Antibodies / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007109:Immunity; D016031:Liver Transplantation; D019520:Living Donors; D018655:Lymphocyte Count; D008875:Middle Aged; D066027:Transplant Recipients
chemical_list: D000017:ABO Blood-Group System; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines
keywords: ABO incompatible transplantation; B cell numbers; Hepatitis B immunity; Isohemagglutinins; Rituximab