Renal transplantation across the ABO barrier using A2 kidneys

Ahmed M. Alkhunaizi, Angelo M DeMattos, John M. Barry, William M. Bennett, Douglas J. Norman

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background. The waiting list for cadaveric kidney transplantation has continued to grow, and with the relative scarcity of cadaver donors, the median waiting time for patients in the United States increased to 824 days in 1994. The median waiting times for patients with blood groups B or O were 1329 and 1007 days, respectively. Allocation of blood group A2 kidneys (20% of group A) to blood group O and B patients expands their potential donor pool and shortens their waiting time for a kidney transplantation. Methods. Between May 1991 and June 1998, we transplanted 15 A2 kidneys into 6 blood group O and 9 blood group B patients. Anti-A isoagglutinins were measured before transplantation, and patients with anti-A1 titers ≥1:8 underwent plasmapheresis (PP). Results. One patient with high titer anti-A antibodies, who did not receive PP, lost her allograft because of hyperacute rejection. Allograft function was excellent in the remaining 14 patients, with a mean serum creatinine level of 1.7 (±0.89) mg/dl at 1 month and 1.3 (±-0.34) mg/dl at 1 year. The actuarial 1-year graft survival rate was 93.3±6.4% and the patient survival rate was 100%. Conclusion. We conclude that the allocation of blood group A2 kidneys for blood group O and B recipients is a practical way to expand the donor pool for these transplant candidates. PP may be important for reducing the levels of anti-A1 and anti-A2 antibodies and for reducing the risk of hyperacute rejection. Splenectomy seems to be unnecessary.

Original languageEnglish (US)
Pages (from-to)1319-1324
Number of pages6
JournalTransplantation
Volume67
Issue number10
DOIs
StatePublished - May 27 1999
Externally publishedYes

Fingerprint

varespladib methyl
Kidney Transplantation
Blood Group Antigens
Kidney
Plasmapheresis
Tissue Donors
Allografts
Anti-Idiotypic Antibodies
Survival Rate
Waiting Lists
Graft Survival
Splenectomy
Cadaver
Creatinine
Transplantation
Transplants
Serum

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Alkhunaizi, A. M., DeMattos, A. M., Barry, J. M., Bennett, W. M., & Norman, D. J. (1999). Renal transplantation across the ABO barrier using A2 kidneys. Transplantation, 67(10), 1319-1324. https://doi.org/10.1097/00007890-199905270-00005

Renal transplantation across the ABO barrier using A2 kidneys. / Alkhunaizi, Ahmed M.; DeMattos, Angelo M; Barry, John M.; Bennett, William M.; Norman, Douglas J.

In: Transplantation, Vol. 67, No. 10, 27.05.1999, p. 1319-1324.

Research output: Contribution to journalArticle

Alkhunaizi, AM, DeMattos, AM, Barry, JM, Bennett, WM & Norman, DJ 1999, 'Renal transplantation across the ABO barrier using A2 kidneys', Transplantation, vol. 67, no. 10, pp. 1319-1324. https://doi.org/10.1097/00007890-199905270-00005
Alkhunaizi, Ahmed M. ; DeMattos, Angelo M ; Barry, John M. ; Bennett, William M. ; Norman, Douglas J. / Renal transplantation across the ABO barrier using A2 kidneys. In: Transplantation. 1999 ; Vol. 67, No. 10. pp. 1319-1324.
@article{1fba933faf5c44df89eab1563aefd893,
title = "Renal transplantation across the ABO barrier using A2 kidneys",
abstract = "Background. The waiting list for cadaveric kidney transplantation has continued to grow, and with the relative scarcity of cadaver donors, the median waiting time for patients in the United States increased to 824 days in 1994. The median waiting times for patients with blood groups B or O were 1329 and 1007 days, respectively. Allocation of blood group A2 kidneys (20{\%} of group A) to blood group O and B patients expands their potential donor pool and shortens their waiting time for a kidney transplantation. Methods. Between May 1991 and June 1998, we transplanted 15 A2 kidneys into 6 blood group O and 9 blood group B patients. Anti-A isoagglutinins were measured before transplantation, and patients with anti-A1 titers ≥1:8 underwent plasmapheresis (PP). Results. One patient with high titer anti-A antibodies, who did not receive PP, lost her allograft because of hyperacute rejection. Allograft function was excellent in the remaining 14 patients, with a mean serum creatinine level of 1.7 (±0.89) mg/dl at 1 month and 1.3 (±-0.34) mg/dl at 1 year. The actuarial 1-year graft survival rate was 93.3±6.4{\%} and the patient survival rate was 100{\%}. Conclusion. We conclude that the allocation of blood group A2 kidneys for blood group O and B recipients is a practical way to expand the donor pool for these transplant candidates. PP may be important for reducing the levels of anti-A1 and anti-A2 antibodies and for reducing the risk of hyperacute rejection. Splenectomy seems to be unnecessary.",
author = "Alkhunaizi, {Ahmed M.} and DeMattos, {Angelo M} and Barry, {John M.} and Bennett, {William M.} and Norman, {Douglas J.}",
year = "1999",
month = "5",
day = "27",
doi = "10.1097/00007890-199905270-00005",
language = "English (US)",
volume = "67",
pages = "1319--1324",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Renal transplantation across the ABO barrier using A2 kidneys

AU - Alkhunaizi, Ahmed M.

AU - DeMattos, Angelo M

AU - Barry, John M.

AU - Bennett, William M.

AU - Norman, Douglas J.

PY - 1999/5/27

Y1 - 1999/5/27

N2 - Background. The waiting list for cadaveric kidney transplantation has continued to grow, and with the relative scarcity of cadaver donors, the median waiting time for patients in the United States increased to 824 days in 1994. The median waiting times for patients with blood groups B or O were 1329 and 1007 days, respectively. Allocation of blood group A2 kidneys (20% of group A) to blood group O and B patients expands their potential donor pool and shortens their waiting time for a kidney transplantation. Methods. Between May 1991 and June 1998, we transplanted 15 A2 kidneys into 6 blood group O and 9 blood group B patients. Anti-A isoagglutinins were measured before transplantation, and patients with anti-A1 titers ≥1:8 underwent plasmapheresis (PP). Results. One patient with high titer anti-A antibodies, who did not receive PP, lost her allograft because of hyperacute rejection. Allograft function was excellent in the remaining 14 patients, with a mean serum creatinine level of 1.7 (±0.89) mg/dl at 1 month and 1.3 (±-0.34) mg/dl at 1 year. The actuarial 1-year graft survival rate was 93.3±6.4% and the patient survival rate was 100%. Conclusion. We conclude that the allocation of blood group A2 kidneys for blood group O and B recipients is a practical way to expand the donor pool for these transplant candidates. PP may be important for reducing the levels of anti-A1 and anti-A2 antibodies and for reducing the risk of hyperacute rejection. Splenectomy seems to be unnecessary.

AB - Background. The waiting list for cadaveric kidney transplantation has continued to grow, and with the relative scarcity of cadaver donors, the median waiting time for patients in the United States increased to 824 days in 1994. The median waiting times for patients with blood groups B or O were 1329 and 1007 days, respectively. Allocation of blood group A2 kidneys (20% of group A) to blood group O and B patients expands their potential donor pool and shortens their waiting time for a kidney transplantation. Methods. Between May 1991 and June 1998, we transplanted 15 A2 kidneys into 6 blood group O and 9 blood group B patients. Anti-A isoagglutinins were measured before transplantation, and patients with anti-A1 titers ≥1:8 underwent plasmapheresis (PP). Results. One patient with high titer anti-A antibodies, who did not receive PP, lost her allograft because of hyperacute rejection. Allograft function was excellent in the remaining 14 patients, with a mean serum creatinine level of 1.7 (±0.89) mg/dl at 1 month and 1.3 (±-0.34) mg/dl at 1 year. The actuarial 1-year graft survival rate was 93.3±6.4% and the patient survival rate was 100%. Conclusion. We conclude that the allocation of blood group A2 kidneys for blood group O and B recipients is a practical way to expand the donor pool for these transplant candidates. PP may be important for reducing the levels of anti-A1 and anti-A2 antibodies and for reducing the risk of hyperacute rejection. Splenectomy seems to be unnecessary.

UR - http://www.scopus.com/inward/record.url?scp=0033609324&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033609324&partnerID=8YFLogxK

U2 - 10.1097/00007890-199905270-00005

DO - 10.1097/00007890-199905270-00005

M3 - Article

C2 - 10360584

AN - SCOPUS:0033609324

VL - 67

SP - 1319

EP - 1324

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 10

ER -