Complement fragment C4d deposition in peritubular capillaries in acute humoral rejection after ABO blood group-incompatible human kidney transplantation

2003 ◽  
Vol 75 (5) ◽  
pp. 663-665 ◽  
Author(s):  
Masako Kato ◽  
Kunio Morozumi ◽  
Oki Takeuchi ◽  
Tadashi Oikawa ◽  
Katsushi Koyama ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Blood Group ◽  
Human Kidney ◽  
Abo Blood Group ◽  
Humoral Rejection ◽  
Peritubular Capillaries

ABO blood group incompatibility: a diminishing barrier to successful kidney transplantation?

2010 ◽  
Vol 6 (6) ◽  
pp. 893-900 ◽  
Author(s):  
Joseph Kahwaji ◽  
Ashley A Vo ◽  
Stanley C Jordan
Keyword(s):  
Kidney Transplantation ◽  
Blood Group ◽  
Abo Blood Group

scholarly journals ABO-Incompatible Kidney Transplant Outcomes

2018 ◽  
Vol 13 (8) ◽  
pp. 1234-1243 ◽  
Author(s):  
Annelies E. de Weerd ◽  
Michiel G.H. Betjes
Keyword(s):  
Kidney Transplantation ◽  
Confidence Interval ◽  
Kidney Transplant ◽  
Blood Group ◽  
Observational Studies ◽  
Abo Blood Group ◽  
Safe Procedure ◽  
Kidney Transplant Recipients ◽  
Antibody Mediated Rejection ◽  
Statistical Heterogeneity

Background and objectivesABO blood group–incompatible kidney transplantation is considered a safe procedure, with noninferior outcomes in large cohort studies. Its contribution to living kidney transplantation programs is substantial and growing. Outcomes compared with center-matched ABO blood group–compatible control patients have not been ascertained.Design, setting, participants, & measurementsComprehensive searches were conducted in Embase, Medline, Cochrane, Web-of-Science, and Google Scholar. Meta-analyses Of Observational Studies in Epidemiology study guidelines for observational studies and Newcastle Ottawa bias scale were implemented to assess studies. Meta-analysis was performed using Review Manager 5.3. A subgroup analysis on antibody removal technique was performed.ResultsAfter identifying 2728 studies addressing ABO-incompatible kidney transplantation, 26 studies were included, describing 1346 unique patients who were ABO-incompatible and 4943 ABO-compatible controls. Risk of bias was low (all studies ≥7 of 9 stars). Baseline patient characteristics revealed no significant differences in immunologic risk parameters. Statistical heterogeneity of studies was low (I2 0% for graft and patient survival). One-year uncensored graft survival of patients who were ABO-incompatible was 96% versus 98% in ABO-compatible controls (relative risk, 0.97; 95% confidence interval, 0.96 to 0.98; P<0.001). Forty-nine percent of reported causes of death in patients who were ABO-incompatible were of infectious origin, versus only 13% in patients who were ABO-compatible (P=0.02). Antibody-mediated rejection (3.86; 95% confidence interval, 2.05 to 7.29; P<0.001), severe nonviral infection (1.44; 95% confidence interval, 1.13 to 1.82; P=0.003), and bleeding (1.92; 95% confidence interval, 1.36 to 2.72; P<0.001) were also more common after ABO-incompatible transplantation.ConclusionsABO-incompatible kidney transplant recipients have good outcomes, albeit inferior to center-matched ABO-compatible control patients.

scholarly journals Antibody-Mediated Rejection in Kidney Transplant Recipients

2013 ◽  
Vol 67 (1) ◽  
pp. 2-8
Author(s):  
Rafails Rozentâls ◽  
Ieva Ziediņa
Keyword(s):  
Kidney Transplantation ◽  
Transplant Recipients ◽  
Humoral Rejection ◽  
Kidney Transplant Recipients ◽  
Hla Antibodies ◽  
Antibody Mediated Rejection ◽  
Peritubular Capillaries ◽  
Before And After ◽  
The One ◽  
Clinical Changes

This paper provides a review of the significant problem of humoral, or antibody-mediated rejection, in kidney transplantation. The main cause of antibody-mediated rejection is donor-specific anti-HLA antibodies. Patients with anti-HLA antibodies are called sensitised patients. The outcome of humoral rejection is unfavourable: graft dysfunction and failure have been frequent from the early post-transplant period and are continuing. International laboratories and clinics offer sensitive and accurate methods to determine antibodies before and after kidney transplantation, but the methods are not always successful in recognition of sensitised patients. For diagnostics of humoral rejection the important issue is detecting complement breakdown deposition (C4d) in peritubular capillaries during immunohistological examination. On the one hand, their presence is characteristic for humoral rejection, but on the other hand, they can occur without any clinical changes or can remain undetected during severe humoral rejection. Current methods of prevention, diagnostics and treatment of humoral rejection are discussed. Difficulties of evaluation of chronic antibody-mediated injury are particularly highlighted.

scholarly journals ABO Incompatible Kidney Transplantation—Current Status and Uncertainties

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Milljae Shin ◽  
Sung-Joo Kim
Keyword(s):  
Kidney Transplantation ◽  
Blood Group ◽  
Current Status ◽  
Abo Blood Group ◽  
Absolute Contraindication ◽  
Kidney Allograft ◽  
Antibody Mediated Rejection ◽  
The Past

In the past, ABO blood group incompatibility was considered an absolute contraindication for kidney transplantation. Progress in defined desensitization practice and immunologic understanding has allowed increasingly successful ABO incompatible transplantation during recent years. This paper focused on the history, disserted outcomes, desensitization modalities and protocols, posttransplant immunologic surveillance, and antibody-mediated rejection in transplantation with an ABO incompatible kidney allograft. The mechanism underlying accommodation and antibody-mediated injury was also described.

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