Implications of the Kidd blood group system in renal transplantation

Abstract

The association of the Kidd blood group system with hemolytic transfusion reactions and hemolytic disease of the newborn is well known. The Kidd antigens, which are localized to the HUT/UT-B urea transport protein, are found on red blood cells and the endothelial cells of the blood vessels of the medulla of the kidney. Recently it has been suggested that these antigens might play a role as minor histocompatibility antigens in renal transplantation. In the current case, the appearance of an anti-Jk b 10 years after renal transplantation associated with early renal allograft rejection further supports the potential importance of these antigens in renal transplantation and allograft rejection.

Blood Management in a Liver Transplant Recipient with Kidd (Jka) and Rhesus (D) Antibodies: A Case Report

“…both Jk(a) and Jk(b) antigens also function as minor histocompatibility antigens and have been associated with acute rejection. [7][8][9][10][11][12] Procurement of compatible RBCs for this patient was challenging as individuals with blood type O who require Jk(a), and RhD-negative RBCs, are a minority (likely <1%) of the donor population. While matching blood products is essential in avoiding HTRs, it is also necessary to minimize delays in organ donation, which may increase risks of graft function with prolonged cold ischemic time.…”

“…both Jk(a) and Jk(b) antigens also function as minor histocompatibility antigens and have been associated with acute rejection. 7–12…”

The potential role of antibodies against minor blood group antigens in renal transplantation

“…All rights reserved been described [31,32]. Rourke et al described a patient developing late rejection, 10 years post-transplantation in the setting of poor compliance and the development of an anti-Jk b antibody [33]. In a study examining 370 patients who had undergone renal transplantation to determine whether Kidd or Duffy antigen mismatches between donor and recipient caused increased rates of graft loss, no difference in graft survival was found between those with donor recipient mismatch and those who were matched.…”