title: Impact of donor ABH-secretor status in ABO-mismatched living donor kidney transplantation.
abstract: The ABO blood group is a major determinant in living donor kidney transplantation since AB antigens are expressed on renal tissue. Little attention has been directed to the ABH-secretor status of the donor kidney. As renal tissue is capable of secreting soluble ABH antigens in secretors, we examined the influence of the ABH-secretor status of kidney donors on outcome in ABO-mismatched living donor kidney transplantation.
  
  
  
  We retrospectively analyzed all patients who underwent ABO-mismatched kidney transplantation at the University Hospital Basel from September 2005 to October 2013. The ABH-secretor status was determined in all donors by molecular genetic analysis.
  
  
  
  Of all 55 patients who received transplants, we excluded all patients with donor-specific antibodies (n = 4). Forty-one donors were secretors (78%) and 11 were nonsecretors (22%). Recipients of ABH-secretor donor organs showed a significantly higher glomerular filtration rate throughout the first 6 months posttransplant, whereas no significant influence on posttransplant anti-A/B titers was found. Regression analysis revealed a significant impact on humoral rejection, whereas not on vascular or interstitial rejection in protocol kidney biopsies.
  
  
  
  The donor ABH-secretor status may have an influence on early posttransplant renal function in patients undergoing ABO-mismatched living donor kidney transplantation. Further prospective studies with long-term follow-up are needed to elucidate involved pathomechanisms.
authors.affiliation: Department of Haematology, University Hospital Basel, Basel. drexlerb@uhbs.ch.|Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland. drexlerb@uhbs.ch.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Drexler
authors.affiliation: Department of Haematology, University Hospital Basel, Basel.|Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Holbro
authors.affiliation: Blood Transfusion Centre, Swiss Red Cross, Aarau, Switzerland.
authors.forename: Joerg
authors.initials: J
authors.lastname: Sigle
authors.affiliation: Blood Transfusion Service, Swiss Red Cross, Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Gassner
authors.affiliation: Blood Transfusion Service, Swiss Red Cross, Zurich, Switzerland.
authors.forename: Beat M
authors.initials: BM
authors.lastname: Frey
authors.affiliation: Clinic for Transplant Immunology and Nephrology.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schaub
authors.affiliation: Clinic for Transplant Immunology and Nephrology.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Amico
authors.affiliation: Department of Haematology, University Hospital Basel, Basel.|Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Plattner
authors.affiliation: Department of Haematology, University Hospital Basel, Basel.|Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland.
authors.forename: Laura
authors.initials: L
authors.lastname: Infanti
authors.affiliation: Institute for Pathology, University Hospital Basel, Basel, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Menter
authors.affiliation: Institute for Pathology, University Hospital Basel, Basel, Switzerland.
authors.forename: Michael Jörg
authors.initials: MJ
authors.lastname: Mihatsch
authors.affiliation: Immunotherapy Laboratory, Department of Biomedicine, University Hospital Basel, Basel, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Stern
authors.affiliation: Department of Haematology, University Hospital Basel, Basel.|Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland.
authors.forename: Andreas
authors.identifier: 0000-0002-7942-6746
authors.initials: A
authors.lastname: Buser
authors.affiliation: Clinic for Transplant Immunology and Nephrology.
authors.forename: Michael
authors.initials: M
authors.lastname: Dickenmann
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D001787:Blood Group Incompatibility / Q000276:immunology*; D005260:Female; D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000017:ABO Blood-Group System