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Acquired Downregulation of Donor‐Specific Antibody Production After ABO ‐Incompatible Kidney Transplantation
Author(s) -
Tasaki M.,
Saito K.,
Nakagawa Y.,
Imai N.,
Ito Y.,
Aoki T.,
Kamimura M.,
Narita I.,
Tomita Y.,
Takahashi K.
Publication year - 2017
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.13937
Subject(s) - abo blood group system , medicine , downregulation and upregulation , abo incompatibility , kidney transplantation , antibody , transplantation , immunology , donor specific antibodies , surgery , biology , genetics , gene
The mechanism of long‐term B cell immunity against donor blood group antigens in recipients who undergo ABO ‐incompatible ( ABO i) living‐donor kidney transplantation ( LKT x) is unknown. To address this question, we evaluated serial anti‐A and anti‐B antibody titers in 50 adult recipients. Donor‐specific antibody titers remained low (≤1:4) in 42 recipients (84%). However, antibodies against nondonor blood group antigens were continuously produced in recipients with blood type O. We stimulated recipients' peripheral blood mononuclear cells in vitro to investigate whether B cells produced antibodies against donor blood group antigens in the absence of graft adsorption in vivo . Antibodies in cell culture supernatant were measured using specific enzyme‐linked immunosorbent assays ( ELISAs ). Thirty‐five healthy volunteers and 57 recipients who underwent ABO ‐compatible LKT x served as controls. Antibody production in vitro against donor blood group antigens by cells from ABO i LKT x patients was lower than in the control groups. Immunoglobulin deposits were undetectable in biopsies of grafts of eight recipients with low antibody titers (≤1:4) after ABO i LKT x. One patient with blood type A1 who received a second ABO i LKT x from a type B donor did not produce B‐specific antibodies. These findings suggest diminished donor‐specific antibody production function in the setting of adult ABO i LKT x.