The histo‐blood group ABO system and tissue transplantation

Abstract

In general, one might expect that ABO incompatibility of donor and recipient would be important to some degree if viability of the transplanted allograft is important for graft incorporation and function. This is true for some recipients of organs. However, ABO incompatibility appears to play a minor role, if any, in the clinical success of viable cornea and viable skin allografts. Even though A and B antigens may be present on the transplanted tissue, other factors that can contribute include the strength of the immune response, the avidity of the antibody, and the dose of the antigen presented, which may vary from donor to donor. Although A and B antigens are present on endothelium, the use of ABO-incompatible heart valves is successful, as they carry out their mechanical function by using the strength of the connective tissue rather than the viability of the donor endothelium. The presence, immunogenicity, and significance of A and B antigens in human vessel transplants have not been well studied. With the more commonly transplanted tissue, such as bone and tendon, posttransplant success does not depend on cellular viability or ABO compatibility.

Consequences of ABO incompatibility in allogeneic hematopoietic stem cell transplantation

“…In this regard it is of interest that ABO antigens are not only expressed on RBC but also on endothelial cells as well as on plasma proteins such as the von Willebrand factor. 24 Thus, ABO antigens show a broad distribution throughout body tissues, 25,26 and anti-host A/B antibodies produced after minor or bidirectional ABOincompatible SCT may bind to and damage the host endo-thelium potentially triggering GVHD. In support of this hypothesis, Bacigalupo and colleagues 9 found a higher risk of developing acute GVHD in patients receiving minor ABO-incompatible SCT when compared to ABO-identical SCT.…”

ABO and RhD Blood Groups in Nasal Polyposis

“…The antigens of the ABO blood group system are complex carbohydrate molecules. Besides being expressed on the surface of red blood cells, ABO antigens are strongly expressed on the surface of a variety of human cells and tissues, including the epithelium, sensory neurons, platelets, and vascular endothelium (2). The oligosaccharide composition of the cell membrane and mucosal secretions is controlled in part by the ABO system and influences the adhesion of environmental factors to epithelial cells, thereby modulating viral and bacterial respiratory tract infections (3).…”

Pre-transplant reduction of isohaemagglutinin titres by donor group plasma infusion does not reduce the incidence of pure red cell aplasia in major ABO-mismatched transplants

“…1,2 ABO antigens are potently immunogenic and are expressed on multiple tissues in addition to red blood cells. 3 Since ABO and human leukocyte antigens (HLA) are inherited independently, ABO incompatibility may occur in 20-40% of HLA-matched allogeneic haematopoietic stem cell transplants (SCT). 2 Graft failure does not occur with increased frequency, and most studies indicate that the incidence of graft-versus-host disease (GVHD) is not increased following ABO-incompatible transplants.…”

“…10,11 Reduction of incompatible isohaemagglutinin titres prior to transplant, either by plasma exchange, immunoadsorption or donortype RBC infusion, has been utilized in the past. [2][3][4][5][6][7][8][9][10][11][12][13][14] However, this practice has been highly variable and there are no specific recommendations. In addition, limited data suggest that this reduction in pre-transplant titres also reduces the incidence of PRCA.…”