Immune anti‐A₁ in A₂ recipients of kidneys from group O donors

Abstract

Antibodies specific for recipient red cell antigens have been demonstrated in patients who receive organs from ABO unmatched donors. In some cases, severe but self-limited hemolysis has been associated with the development of posttransplantation antibodies. We report a case in which an A2 recipient of a kidney from a group O donor formed anti-A1 antibody which reacted with homologous red cells. The patient developed a delayed hemolytic transfusion reaction. A radiochromium survival study revealed decreased survival of A1 red cells. A broader specificity of the antibody was not shown during follow-up. The anti-A1 was not detected in a sample tested 6 months after the initial study. It is probable that the anti-A1 noted in this case was formed by passenger lymphocytes. A2 patients who develop anti-A1 after renal transplantation should be transfused with red cells negative for A1.

<p>Prevalence of A₂ and A₂B Subgroups and Anti-A₁ Antibody in Blood Donors in Jazan, Saudi Arabia</p>

“…18,19 Development of anti-A 1 antibodies after allogeneic stem cell transplantation and organ transplantation has also been reported. 7,20 It has been reported that individuals with A 2 B phenotype are more prone to develop anti-A 1 as compared to A 2 . This could be explained on the basis of two observations.…”

“… 18 , 19 Development of anti-A 1 antibodies after allogeneic stem cell transplantation and organ transplantation has also been reported. 7 , 20 …”

“…5,6 Anti-A 1 is important as it is one of the causes of ABO discrepancies, it can develop hemolytic transfusion reaction and its clinical manifestations have also been reported in hemopoietic stem cell and organ transplantation. 7,8 To the best of the authors' knowledge no local study has been conducted to evaluate the frequency of A 2 , A 2 B phenotypes and anti-A 1 in normal individuals in Saudi Arabia. The aim of this study was to determine the frequency of A 2 , A 2 B, and anti-A 1 in blood donors in Jazan, Saudi Arabia.…”

“…5 , 6 Anti-A 1 is important as it is one of the causes of ABO discrepancies, it can develop hemolytic transfusion reaction and its clinical manifestations have also been reported in hemopoietic stem cell and organ transplantation. 7 , 8 …”

Severe haemolysis after an ABO unmatched kidney transplant — a nonsecretor transplanted from a donor with high anti‐A titre

“…In addition, antibodies were most frequently seen in group A recipients receiving group O grafts (Ramsay, 1991). It has been suggested that group A 1 recipients are more at risk of haemolysis as they have more antigenic sites than group A 2 (Mangal et al, 1984b;Bracey & Van Buren, 1986). A 2 also differs qualitatively from A 1 in that A 2transferase is unable to convert Type 3H and Type 4H structures to Type 3A and 4A, respectively.…”