title: Successful ABO-Incompatible Renal Transplantation:  Blood Group A1B Donor Into A2B Recipient With Anti-A1 Isoagglutinins.
abstract: OBJECTIVE
  Transplantation of the blood group A2B in a recipient was successfully performed in the setting of receiving a deceased donor kidney from an "incompatible" A1B donor.
  
  
  METHODS
  The donor and recipient were both typed for ABO blood group, including ABO genotyping. The donor and recipient were tested for ABO, non-ABO, and human leukocyte antigen (HLA) antibodies. The donor and recipient were typed for HLA antigens, including T- and B-flow cytometry crossmatch tests.
  
  
  RESULTS
  The recipient's RBCs were negative with A1 lectin, and immunoglobulin G anti-A1 was demonstrated in the recipient's plasma. The donor-recipient pair was a four-antigen HLA mismatch, but final T- and B-flow cytometry crossmatch tests were compatible. The transplant procedure was uneventful; the patient experienced immediate graft function with no episodes of rejection or readmissions more than 2 years later.
  
  
  CONCLUSIONS
  It may be safe to transplant across the A1/A2 blood group AB mismatch barrier in the setting of low titer anti-A1 isoagglutinins without the need for pretransplant desensitization even if the antibody produced reacts with anti-human globulin.
authors.affiliation: From the Departments of Pathology efadeyi@wakehealth.edu.
authors.forename: Emmanuel A
authors.initials: EA
authors.lastname: Fadeyi
authors.affiliation: Surgery, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stratta
authors.affiliation: Surgery, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Farney
authors.affiliation: From the Departments of Pathology.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Pomper
mesh_terms: D000017:ABO Blood-Group System / Q000097:blood*; D000328:Adult; D001787:Blood Group Incompatibility / Q000097:blood*; D001788:Blood Grouping and Crossmatching; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D014019:Tissue Donors
chemical_list: D000017:ABO Blood-Group System
keywords: ABO incompatible; Antibody-mediated rejection; HLA mismatch; Immunology; Renal transplant; Special topics; Transfusion medicine