Hyporesponsiveness against donor's ABO antigens of renal grafts after ABO-incompatible kidney transplantation
Hyporesponsiveness against donor's ABO antigens of renal grafts after ABO-incompatible kidney transplantation
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DOI：
10.1007/s10157-022-02280-3
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发表时间：
2022-10-08
影响因子：
2.3
通讯作者：
Tomita，Yoshihiko
中科院分区：
文献类型：
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作者：
Tasaki，Masayuki;Tateno，Hiroaki;Tomita，Yoshihiko
背景表达于红细胞(RBC)上的ABO抗原与表达于肾内皮细胞上的ABO抗原不同。使用红细胞的同种血凝素试验是评估抗ABO抗体水平的金标准。然而，目前尚不清楚ABO血型不合(ABO)血型不合(ABOI)肾移植(KTX)后检测到的抗ABO抗体是否能与移植肾内皮细胞结合。结果ABOc KTX后，同种血凝素试验和CD31-ABO芯片检测的抗体滴度具有相关性。然而，CD31-ABO芯片结果显示ABOKTX后针对供者血型抗原的抗体水平较低，并且与同种血凝素试验没有相关性。相比之下，ABOI KTX后对非献血者血型抗原的抗体水平与ABOc KTX后相当。14例患者接受移植肾活检，除2例抗供者HLAAbs阳性外，ABOIKTX受者均未观察到抗体介导的排斥反应。结论ABOIKTX移植肾功能稳定，其同种异体凝集试验检测到的抗ABO抗体对移植物肾内皮细胞ABO抗原反应较低。
BackgroundABO antigens expressed on the red blood cells (RBCs) are not identical to those expressed on the renal endothelial cells. The isohemagglutinin assay employing the RBCs is the gold standard for evaluating anti-ABO antibody (Ab) levels. However, it remains unclear whether the anti-ABO Abs detected by the isohemagglutinin assay after ABO-incompatible (ABOi) kidney transplantations (KTx) that are not associated with antibody-mediated rejection can bind to renal graft endothelial cells.MethodsNinety plasma samples were collected from patients with stable graft function after ABO-compatible (ABOc) or ABOi KTx. Anti-ABO Ab titers were examined by both the isohemagglutinin assay and the CD31-ABO microarray, which was developed as a mimic of the ABO antigens expressed on the renal endothelial cells.ResultsThe antibody titers detected by the isohemagglutinin assay and the CD31-ABO microarray after the ABOc KTx relatively correlated with each other. However, the CD31-ABO microarray results showed low antibody levels against donor blood group antigens after ABOi KTx and did not correlate with the isohemagglutinin assay. In contrast, the antibody levels against non-donor blood group antigens after ABOi KTx were comparable to those after the ABOc KTx. Fourteen patients received graft biopsies, and no antibody-mediated rejection was observed in ABOi KTx recipients, except for two patients who had anti-donor-HLA Abs.ConclusionThe present study suggested that the anti-ABO Abs detected by the isohemagglutinin assay after ABOi KTx with stable graft function were hyporeactive to the ABO antigen of graft renal endothelial cells.