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Effects of Neutralization by Soluble ABH Antigens Produced by Transplanted Kidneys From ABO-Incompatible Secretor Donors

 Jieun Kim  ;  Sinyoung Kim  ;  In Sik Hwang  ;  Jong Rak Choi  ;  Jae Geun Lee  ;  Yu Seun Kim  ;  Myoung Soo Kim  ;  Hyun Ok Kim 
 Annals of Laboratory Medicine, Vol.37(3) : 254-260, 2017 
Journal Title
 Annals of Laboratory Medicine 
Issue Date
Adult ; Blood Group Antigens/immunology* ; Blood Group Antigens/metabolism ; Blood Group Incompatibility/immunology* ; Creatinine/blood ; Female ; Fucosyltransferases/genetics ; Genotype ; Graft Rejection/diagnosis ; Graft Rejection/mortality ; Humans ; Immunoglobulin G/blood ; Immunoglobulin G/immunology ; Immunoglobulin M/blood ; Immunoglobulin M/immunology ; Kidney Failure, Chronic/therapy ; Kidney Transplantation* ; Male ; Middle Aged ; Retrospective Studies ; Sequence Analysis, DNA ; Survival Rate ; Tissue Donors ; Transplantation, Homologous
Blood group antigens ; Blood group incompatibility ; Graft survival ; Kidney transplantation ; β-galactoside α-1,2-fucosyltransferase
BACKGROUND: Grafts survive despite blood group antigens on the transplant being continuously exposed to antibodies in the blood of recipients in ABO-incompatible kidney transplantation (ABOi KT), owing to the mechanism of accommodation. We analyzed the immunodynamics of soluble ABH antigens in allografts from secretor donors and the influence of such immunodynamics on accommodation and subsequent graft survival in ABOi KT. METHODS: The genotype of a known human β-galactoside α-1,2-fucosyltransferase gene (FUT2), which determines soluble ABH antigen secretor status, was established in 32 donors for ABOi KT at the Severance Hospital, from June 2010 to July 2015. Clinical outcomes of recipients, such as anti-A/B antibody titer change, renal function, and graft survival, were evaluated. RESULTS: Twenty-five donors were secretors (78.1%), and seven were nonsecretors (21.9%). The frequency of anti-A/B IgG or IgM antibody titer elevation or reduction post-transplantation was not significantly related to donor secretor status. However, IgM titer was rapidly reduced in recipients transplanted from nonsecretor donors (P=0.01), which could be explained by the lack of absorption effect of soluble antigens, enhancing the binding of antibodies to antigens in the allografts. Interestingly, soluble ABH antigens did not affect rejection-free graft survival, which may be due to the nature of β-galactoside α-1,2-fucosyltransferase. CONCLUSIONS: Soluble ABH antigens produced by transplanted kidneys from secretor donors played a role in inducing accommodation within three months of KT through neutralization; however, major graft outcomes were not affected.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
김명수(Kim, Myoung Soo) ORCID logo https://orcid.org/0000-0002-8975-8381
김신영(Kim, Sin Young) ORCID logo https://orcid.org/0000-0002-2609-8945
김유선(Kim, Yu Seun) ORCID logo https://orcid.org/0000-0002-5105-1567
김지은(Kim, Jieun)
김현옥(Kim, Hyun Ok) ORCID logo https://orcid.org/0000-0002-4964-1963
이재근(Lee, Jae Geun) ORCID logo https://orcid.org/0000-0002-6722-0257
최종락(Choi, Jong Rak) ORCID logo https://orcid.org/0000-0002-0608-2989
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