title: A2 to B Blood Type Incompatible Deceased Donor Kidney Transplantation in a Recipient Infected with the Human Immunodeficiency Virus: A Case Report.
abstract: BACKGROUND
  With the introduction of the Kidney Allocation System in the United States in December 2014, transplant centers can list eligible B blood type recipients for A2 organ offers. There have been no prior reports of ABO incompatible A2 to B deceased donor kidney transplantation in human immunodeficiency virus-positive (HIV+) recipients to guide clinicians on enrolling or performing A2 to B transplantations in HIV+ candidates. We are the first to report a case of A2 to B deceased donor kidney transplantation in an HIV+ recipient with good intermediate-term results.
  
  
  RESULTS
  We describe an HIV+ 39-year-old African American man with end-stage renal disease who underwent A2 to B blood type incompatible deceased donor kidney transplantation. Prior to transplantation, he had an undetectable HIV viral load. The patient was unsensitized, with his most recent anti-A titer data being 1:2 IgG and 1:32 IgG/IgM. Induction therapy of basiliximab and methylprednisolone was followed by a postoperative regimen of plasma exchange, intravenous immunoglobulin, and rituximab with maintenance on tacrolimus, mycophenolate mofetil, and prednisone. He had delayed graft function without rejection on allograft biopsy. Nadir serum creatinine was 2.0 mg/dL. He continued to have an undetectable viral load on the same antiretroviral therapy adjusted for renal function.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of A2 to B deceased donor kidney transplantation in an HIV+ recipient with good intermediate-term results, suggesting that A2 donor kidneys may be considered for transplantation into HIV+ B-blood type wait list candidates.
authors.affiliation: Department of General Surgery, Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: rachel.forbes@vanderbilt.edu.
authors.forename: R C
authors.initials: RC
authors.lastname: Forbes
authors.affiliation: Department of General Surgery, Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: A
authors.initials: A
authors.lastname: DeMers
authors.affiliation: Department of Internal Medicine, Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: B P
authors.initials: BP
authors.lastname: Concepcion
authors.affiliation: Department of General Surgery, Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Moore
authors.affiliation: Department of Internal Medicine, Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Schaefer
authors.affiliation: Department of General Surgery, Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: D
authors.initials: D
authors.lastname: Shaffer
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D001787:Blood Group Incompatibility; D051799:Delayed Graft Function / Q000097:blood / Q000821:virology; D015658:HIV Infections / Q000097:blood* / Q000601:surgery / Q000821:virology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000601:surgery / Q000821:virology; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System