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

Holt, Stephen; Kotagiri, Prasanti; Hogan, Chris; Hughes, Peter; Masterson, Rosemary

doi:10.1111/tri.13685

Cited by 6 publications

(9 citation statements)

References 36 publications

(50 reference statements)

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“…We present this case of a blood type O LT recipient who presented with a rare combination of anti-D and anti-Jk(a) antibodies, necessitating coordination with the blood bank and supplier to obtain timely dual antigen-negative RBCs for transfusion to prevent potential HTRs in a high-risk patient. 2,3 As transplantation in patients with liver failure is associated with anticipated risks of bleeding due to impaired coagulation, significant perioperative hemostatic and RBC support was anticipated. This infrequently described clinical challenge of Kidd blood system antibodies in a Rhesus −ve patient is the basis for this report and may be of interest to anesthesiologists.…”

Section: Discussionmentioning

confidence: 99%

“…Jk(a) is common (present in a high frequency of 73% to 90% with some ethnic variation), Jk(b) is less prevalent (49%–90%), and Jk (a−b−) is extremely rare. 1,2 The Kidd antigens are also expressed in the renal endothelium. Antibodies to either of the Jk antigens may lead to HTRs, not only the delayed form as with other non-ABO IgG antibodies but also the acute form due to Jk antibodies’ unique ability of complement activation leading to extravascular and intravascular hemolysis.…”

Section: Discussionmentioning

confidence: 99%

“…1 In transplant recipients, the presence of Jk antibodies is known to be associated with risk of acute and delayed hemolytic transfusion reactions (HTR). 2 The rare occurrence of a preoperative patient with antibodies to both D and Jk phenotypes has not been reported. Given the infrequent presentation, there may be logistical challenges in obtaining Jk negative red blood cells (RBCs) perioperatively, especially in the presence of added anti-D Rhesus antibodies.…”

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confidence: 99%

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

Butler,

Hundley,

Lin

et al. 2024

A&A Practice

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A 67-year-old man presented for urgent liver transplantation (LT). Screening revealed the rare combination of antiRhesus (D) and antiKidd Jk(a) antibodies, requiring antigen-negative red blood cells (RBC) for both phenotypes. This combination has not been reported during LT. Compatible RBCs were initially limited, requiring continued communication between the blood bank/blood supplier to obtain more, including frozen, units. Additional strategies included the use of cell salvage and intentional management of coagulopathy to limit bleeding and RBC requirement. This case highlights blood management during LT when D and Jk(a) antibodies may limit RBC supply and emphasizes the need for effective communication with the blood bank.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Butler,

Hundley,

Lin

et al. 2024

A&A Practice

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“…There are over 35 minor blood group antigens on red blood cells [21], some of which including P and Lewis, are widely distributed in other human cells and body fluids [43,44]. Minor blood groups have been associated with several diseases ranging from malignancy to peptic ulcer disease, infection and CVD [43,44].…”

Section: Minor Blood Group Antigens and Cvdmentioning

confidence: 99%

Are ABO Gene Alleles Responsible for Cardiovascular Diseases and Venous Thromboembolism and Do They Play a Role in COVID?

Cordato¹,

Soubra²,

Saleem³

et al. 2022

Blood Groups - More Than Inheritance of Antigenic Substances

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Cardiovascular diseases (CVD) including coronary heart disease and stroke are leading causes of death and disability globally. Studies of the association between ABO blood groups and CVD have consistently demonstrated an increased risk of coronary heart disease, myocardial infarction, cerebral ischaemic stroke, peripheral arterial disease and venous thromboembolism (VTE) including deep vein thrombosis and pulmonary thromboembolism in patients who possess a non-O blood group type. The most likely mechanism is thought to be the increase in von Willebrand Factor (vWF) and factor VIII levels seen in patients with a non-O blood group. Other postulated mechanisms include elevations in circulating inflammatory markers such as endothelial cell and platelet adhesion molecules in subjects with a non-O blood group. More recently, it has also been recognised that individuals with a non-O blood group type carry a higher risk of SARS-C0V-2 infection and COVID-19 related complications. The increased levels in vWF and factor VIII amongst individuals with a non-O blood group who have contracted SARS-CoV-2 infection may result in an additive thrombophilic effect to that caused by the SARS-CoV-2 virus. Another postulated mechanism is that individuals with an O-blood group are protected by anti-A and B antibodies which possibly inhibit the binding of the SARS-CoV-2 spike protein to lung epithelium angiotensin converting enzyme-2 receptors. There are over 35 minor blood groups on red blood cells, some of which such as Kidd, Lewis and Duffy have been associated with CVD either alone or in combination with a non-O blood group allele(s). However, their role in SARS-CoV-2 infection and mechanism of action for an association with CVD remain unknown. This review explores the relationship between ABO and minor blood groups with CVD and VTE, with a focus on potential mechanisms underlying this relationship and the potential role of ABO blood group types in COVID.

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“…B. gegen Kollagen IV, peroxisomale Trans-2-enoyl-CoA-Reduktase oder den Phospholipase-A2-Rezeptor diskutiert, inwieweit Autoantikörper bei der Entwicklung einer ABMR beteiligt sind[31]. Da auch eine Immunisierung gegen Blutgruppenmerkmale wie Kidd und Duffy eine ABMR verursachen können, sollte schließlich bei Patienten mit C4d-positiver Biopsie ohne nachweisbaren DSA die Untersuchung auf de novo gebildete, irreguläre erythrozytäre Antikörper in Betracht gezogen werden[32].…”

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Antikörpertestung in der Nierentransplantation

Dick,

Kugyelka,

Humpe

et al. 2023

Nephrologie aktuell

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ZUSAMMENFASSUNGDas HLA-System (HLA: humane Leukozytenantigene) spielt eine wichtige Rolle bei der Transplantation (Tx) der Niere. Daher ist der Nachweis von HLA-Antikörpern vor und nach der Tx entscheidend für die Betreuung des Patienten, wobei verschiedene Verfahren eingesetzt werden. Der Nachweis von donorspezifischen HLA-Antikörpern (DSA) ist gemäß Banff-Klassifikation 1 ein wichtiges Kriterium für die Diagnostik der antikörpervermittelten Abstoßung (ABMR: „antibody-mediated rejection“). Die Untersuchung auf präformierte sowie auf de novo DSA zu verschiedenen Zeitpunkten nach der Tx kann helfen, das individuelle Risiko für eine ABMR zu beurteilen.

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

Abstract: This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as

Cited by 6 publications

References 36 publications

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

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

Are ABO Gene Alleles Responsible for Cardiovascular Diseases and Venous Thromboembolism and Do They Play a Role in COVID?

Antikörpertestung in der Nierentransplantation

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