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A series of surveys on assay for anti‐A/B antibody by Japanese ABO‐incompatible Transplantation Committee
Author(s) -
Kobayashi Takaaki,
Saito Kazuhide
Publication year - 2006
Publication title -
xenotransplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 61
eISSN - 1399-3089
pISSN - 0908-665X
DOI - 10.1111/j.1399-3089.2006.00296.x
Subject(s) - abo blood group system , titer , transplantation , antibody , medicine , antibody titer , institutional review board , serial dilution , immunology , surgery , pathology , alternative medicine
Background: The measurement of anti‐blood groups A and B antibody (Ab) titers is considered to be important in ABO‐incompatible transplantation. However, no standard method for quantitative determination has yet been established in Japan. Inter‐examiner variability was likely because Ab titer was determined mainly by visual observation. In order to assess inter‐institutional variation in the measurement of anti‐A/B Ab titer, a series of surveys was conducted by the Japanese ABO‐incompatible Transplantation Committee. Methods and Results: In 2003, the first national survey was conducted. Serum samples from six healthy volunteers with blood groups A ( n =2), B ( n =2) and O ( n =2) were sent to 29 institutions and anti‐A/B Ab titer was measured by their customary methods. Isohemagglutinin assay in serial‐doubling dilutions of serum using a test tube was widely used in all institutions. Inter‐institutional difference between maximum and minimum value reached as much as 32‐fold in immunoglobulin M (IgM) and 256‐fold in IgG. As detailed protocol for assay seemed to be different between institutions, we attempted to standardize the protocol based on the result of a questionnaire survey. In 2004, a second survey was conducted in the same manner as the previous one, except participation involved 38 institutions and the measurement was performed in a uniform way using a provisional standard protocol. Analysis of the survey revealed that intra‐institutional variation was reduced to below eightfold, except that several institutions showed a large difference from the mean titer and required some guidance. Conclusions: A periodical quality control survey is considered necessary to improve the accuracy of measurement. Anti‐A/B Ab titer would provide useful information towards the prediction of rejection and the indication of treatments such as (double filtration) plasmapheresis, splenectomy, anti‐CD20 monoclonal antibody and intravenous immunoglobulin. Standardization of the assay for anti‐A/B Ab titer is essential for the fulfillment of a precise multicenter study, which will elucidate the significance of the measurement of anti‐A/B Ab titer.