Anti–Blood Group Antibodies in Intravenous Immunoglobulin May Complicate Interpretation of Antibody Titers in ABO-Incompatible Transplantation

Staley, Elizabeth M.; Carruba, S. S.; Manning, Margaret C.; Pham, Huy P.; Williams, Lance A.; Marques, Marisa B.; Locke, Jayme E.; Lorenz, Robin G.

doi:10.1111/ajt.13760

Cited by 14 publications

(10 citation statements)

References 18 publications

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“…In addition, IVIg infusion is believed to reduce infectious complications by substituting depleted immunoglobulins. As a note of caution, IVIg preparations contain IgG antibodies directed against A/B antigens and can effectively increase anti-A/B antibody titers upon administration (12, 13). …”

Section: Desensitization For Aboi Kidney Transplantationmentioning

confidence: 99%

ABO-Incompatible Kidney Transplantation

et al. 2017

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ABO-incompatible (ABOi) kidney transplantation has long been considered a contraindication to successful kidney transplantation. During the last 25 years, increasing organ shortage enforced the development of strategies to overcome the ABO antibody barrier. In the meantime, ABOi kidney transplantation has become a routine procedure with death-censored graft survival rates comparable to the rates in compatible transplantations. Desensitization is usually achieved by apheresis and B cell-depleting therapies that are accompanied by powerful immunosuppression. Anti-A/B antibodies are aimed to be below a certain threshold at the time of ABOi kidney transplantation and during the first 2 weeks after surgery. Thereafter, even a rebound of anti-A/B antibodies does not appear to harm the kidney transplant, a phenomenon that is called accommodation, but is poorly understood. There is still concern, however, that infectious complications such as viral disease, Pneumocystis jirovecii pneumonia, and severe urinary tract infections are increased after ABOi transplantations. Recent data from the Collaborative Transplant Study show that during the first year after kidney transplantation, one additional patient death from an infectious complication occurs in 100 ABOi kidney transplant recipients. Herein, we review the recent evidence on ABOi kidney transplantation with a focus on desensitization strategies and respective outcomes.

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Section: Desensitization For Aboi Kidney Transplantationmentioning

confidence: 99%

ABO-Incompatible Kidney Transplantation

et al. 2017

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“…On the other hand, administration of high-dose IVIG may lead to hemolysis as commercial IVIG may contain anti-A and anti-B isoagglutinins. Using donor blood type or AB-negative blood type plasma that contains approximately 5 grams of immunoglobulin G per unit may be considered[ 41 ].…”

Section: Blood Group Antigens and Kidney Transplantationmentioning

confidence: 99%

ABO incompatibility in renal transplantation

Mohamed

Sweeney

Alkhader

et al. 2021

WJT

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ABO blood group incompatibility (ABO-I) was historically considered an absolute contraindication to kidney transplantation due to the significant risk of acute antibody-mediated rejection and early graft loss. Nevertheless, the urge to minimize the gap between the candidates’ number on the waitlist for kidney transplants and the available kidney donors encourage investigation into finding ways to use organs from ABO-I kidney donors, especially in the era of using more potent immunosuppression therapies. This review aims to discuss a general overview of ABO-I kidney transplantation and the different protocols adopted by some transplant centers to meaningfully overcome this barrier.

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“…The most common method of administration is to give 500 mg IVIG/kg body weight on the day before transplantation. Some authors prefer to divide the IVIG dose and to administer IVIG in two different sessions 4 d and 1 d before transplantation to avoid an excessive volume charge and the possibility of administering isoagglutinins together with IVIG[ 63 , 64 ].…”

Section: Open Controversies In Kidney Transplantation Involving Aboimentioning

confidence: 99%

Current protocols and outcomes of ABO-incompatible kidney transplantation

Salvadori¹,

Tsalouchos²

2020

WJT

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One of the principal obstacles in transplantation from living donors is that approximately 30% are immunologically incompatible because of the presence in the recipient of antibodies directed against the human leukocyte antigen system of the donor or because of the incompatibility of the ABO system. The aim of this review is to describe the more recent data from the literature on the different protocols used and the clinical outcomes of ABO-incompatible kidney transplantation. Two different strategies are used to overcome these barriers: desensitization of the recipient to remove the antibodies and to prevent their rebound after transplantation and the exchange of organs between two or more pairs. The largest part of this review is dedicated to describing the techniques of desensitization. Even if the first reports of successful renal transplantation between ABO-incompatible pairs have been published by 1980, the number of ABO-incompatible transplants increased substantially in this century because of our improved knowledge of the immune system and the availability of new drugs. Rituximab has substantially replaced splenectomy. The technique of apheresis has improved and more recently a tailored desensitization proved to be the more efficient strategy avoiding an excess of immunosuppression with the related side effects. Recent reports document outcomes for such transplantation similar to the outcomes of standard transplantation.

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Anti–Blood Group Antibodies in Intravenous Immunoglobulin May Complicate Interpretation of Antibody Titers in ABO-Incompatible Transplantation

Cited by 14 publications

References 18 publications

ABO-Incompatible Kidney Transplantation

ABO-Incompatible Kidney Transplantation

ABO incompatibility in renal transplantation

Current protocols and outcomes of ABO-incompatible kidney transplantation

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