Blood Group A Isoagglutinins in A2→ O Simultaneous Liver/Kidney Transplantation May Not Influence Kidney Function

• Published in: American journal of transplantation Vol. 11; no. 7; pp. 1527 - 1530
• Main Authors: Bryan, C. F., Abdulkarim, B., Nawabi, A., Stewart, D., Yarlagadda, S. G.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.07.2011; Wiley
• Subjects: A isoagglutinins; A2→ O; Biological and medical sciences; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; SLK; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgery of the urinary system; A; Renal function; Digestive system; Liver; Concurrent; A-Blood group; A isoagglutinins; Homotransplantation; Kidney; O; Treatment; SLK; Urinary system; Surgery; Graft; Kidney transplantation; Liver transplantation
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2011.03575.x

We simultaneously transplanted a liver and kidney (SLK) into a 55‐year‐old woman with end‐stage liver disease secondary to recurrent primary biliary cirrhosis. The patient was blood group O, the donor was A2 (A, non‐A1) and the patient's A isoagglutinin titer was 512. Good renal function was evident by normalization of her creatinine values following transplantation. Recovery was unremarkable and she was discharged on post op day 9. The patient has not experienced an episode of rejection in either organ during the 6 months of follow‐up. This case is important because high A IgG isoagglutinin levels (8 or higher) in kidney alone A2→ O transplantation are detrimental to outcome but do not affect outcome in liver alone A2→ O transplants; however, no such anti‐A titer data have been published for A2→ O (or B) SLK transplantation. One‐year graft outcome in A2 to O simultaneous liver/kidney transplantation (SLK) is comparable to that of ABO‐compatible SLK transplants and represents a strategy to increase O candidates' access to donor organs.