Study of new immunosuppressive strategy and kinetics for ABO incompatible transplantation

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In Japan, the shortage of grafts has encouraged us to perform living donor liver transplantation (LDLT) across the ABO blood barrier. To decide the treatment for an ABO-I recipient, the amount of anti-AB antibody (Ab) is very important. At present, the quantity of anti-AB Ab is represented by the agglutination titer. We developed an enzyme linked immunosorbent assay (ELISA) to measure anti-AB Ab, and assessed its usefulness in clinical practice in this study.In this report, we describe a novel ELISA we have developed to measure anti-histo-blood group Ab in patients subjected to LDLT, which uses synthetic carbohydrate blood group antigens. We assessed the correlation between optical density (O.D.) determined by ELISA and agglutination titers, and considered the possibility of using ELISA in clinical cases. (Tohoku Journal of Experimental Medicine, 211; 359-367,2007) And'' in another study we experienced 9 recipients who underwent apheresis to eliminate allogeneic antibodies, out of 101 LDLT patients. We focused d on the indication and the efficacy of apheresis as extracorporeal immunomodulation for the elimination of antibodies in patients undergoing LDLT. The long-term follow-up was also investigated. (Therapeutic Apheresis and Dialysis; 11(5):319-32.4, 2007) In conclusion, our ELISA method is useful to detect changes in individually anti-A/B Ab and may have the possibility of using ELISA in clinical cases.