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Impact of donor ABH‐secretor status in ABO‐mismatched living donor kidney transplantation
Author(s) -
Drexler Beatrice,
Holbro Andreas,
Sigle Joerg,
Gassner Christoph,
Frey Beat M.,
Schaub Stefan,
Amico Patrizia,
Plattner Alexandra,
Infanti Laura,
Menter Thomas,
Mihatsch Michael Jörg,
Stern Martin,
Buser Andreas,
Dickenmann Michael
Publication year - 2016
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.13711
Subject(s) - abo blood group system , kidney transplantation , medicine , kidney , transplantation , renal function , immunology , gastroenterology
BACKGROUND The ABO blood group is a major determinant in living donor kidney transplantation since AB antigens are expressed on renal tissue. Little attention has been directed to the ABH‐secretor status of the donor kidney. As renal tissue is capable of secreting soluble ABH antigens in secretors, we examined the influence of the ABH‐secretor status of kidney donors on outcome in ABO‐mismatched living donor kidney transplantation. STUDY DESIGN AND METHODS We retrospectively analyzed all patients who underwent ABO‐mismatched kidney transplantation at the University Hospital Basel from September 2005 to October 2013. The ABH‐secretor status was determined in all donors by molecular genetic analysis. RESULTS Of all 55 patients who received transplants, we excluded all patients with donor‐specific antibodies (n = 4). Forty‐one donors were secretors (78%) and 11 were nonsecretors (22%). Recipients of ABH‐secretor donor organs showed a significantly higher glomerular filtration rate throughout the first 6 months posttransplant, whereas no significant influence on posttransplant anti‐A/B titers was found. Regression analysis revealed a significant impact on humoral rejection, whereas not on vascular or interstitial rejection in protocol kidney biopsies. CONCLUSION The donor ABH‐secretor status may have an influence on early posttransplant renal function in patients undergoing ABO‐mismatched living donor kidney transplantation. Further prospective studies with long‐term follow‐up are needed to elucidate involved pathomechanisms.