Current experience with renal transplantation across the ABO barrier

Nelson, Paul W.; Helling, Thomas S.; Shield, Charles F.; Beck, Malcolm L.; Bryan, Christopher

doi:10.1016/s0002-9610(05)81197-3

Cited by 58 publications

(37 citation statements)

References 6 publications

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“…The absence of A antigen on group A 2 platelets is also observed in other tissues, indicating profound suppression of A 2 -transferase activity in nonerythroid tissues. 45,46 One very surprising finding was the linear coexpression of A and H antigens on platelets-unlike RBCs, in which A and H are inversely expressed. On mature RBCs, ABH levels are determined primarily by A/B-glycosyltransferase activity.…”

Section: Discussionmentioning

confidence: 99%

Determinants of ABH expression on human blood platelets

Cooling

Kelly

Barton

et al. 2005

Blood

100

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Section: Discussionmentioning

confidence: 99%

Determinants of ABH expression on human blood platelets

Cooling

Kelly

Barton

et al. 2005

Blood

100

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“…Although the columns have not been tested to a great extent in patients, the capacity to remove anti-A/B antibodies indicates that three sessions will be sufficient to reduce titres to levels of 8 or below (i.e. levels at which it has been shown possible to perform successful transplantations across the ABO barrier) [23]. This new antibody removal may help to alleviate the situation for a number of patients on the waiting list for kidney transplantation who are fortunate to have a living donor but who happen to be ABO incompatible.…”

Section: Biocompatibilitymentioning

confidence: 99%

In vitro assessment of a new ABO immuno-sorbent with synthetic carbohydrates attached to sepharose

Rydberg¹,

Bengtsson²,

Samuelsson³

et al. 2004

Transplant Int

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In vitro assessment of a new A60 immunosorbent with synthetic carbohydrates attached to sepharoseAbstract Transplantation across the ABO barrier is sometimes done in cases of emergency, such as acute liver failure, but is also carried out in elective cases, e.g. kidneys from living donors. Reducing the recipient anti-A/B antibody titres is often necessary in ABO-incompatible kidney transplantation. This is usually done by the use of techniques such as plasmapheresis and protein A-or sepharose-linked anti-human Ig immunoadsorption. A new ABO immunosorbent with synthetic A-or B-trisaccharide carbohydrate epitopes linked to a sepharose matrix has been tested. Columns made of this material have been tested in vitro with plasma from Aand B-individuals, assessed for antibody reduction capacity, flow characteristics, biocompatibility, and unspecific protein adsorption. The columns have a high capacity for ABO antibody removal, reducing titres by three to seven steps in one passage. We noted a high biocompatibility, with no unspecific protein adsorption, no activation of coagulation factors, and a low activation of complement, no immune complex formation and no cytotoxicity towards cultured mammalian L929 cells.

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“…The first principal observation the MTN group made was that high titers of anti-A IgG present in a B or an O patient before A 2 /A 2 B ! B or O transplantation was associated with poor early and late kidney function and graft survival (11). The MTN's first 25 renal transplants were performed without regard to the patient's pretransplantation level of anti-A IgG, because at that time no published evidence existed regarding outcome and pretransplantation anti-A IgG titers (6-9).…”

Section: Introductionmentioning

confidence: 99%

“…B patients was center directed but was no different from that used for ABOcompatible renal transplantation, as long as transplantation was done in patients with a low anti-A IgG history (11,(13)(14)(15)(16). Further, no A 2 /A 2 B !…”

Section: Introductionmentioning

confidence: 99%