ABO‐incompatible kidney transplantation can be successfully conducted by monitoring IgM isoagglutinin titers during desensitization

• DOI: 10.1111/trf.15672
• Publication Date: 2020-01-20T12:14:36Z
• Authors: Hyungsuk Kim; Wonho Choe; Sung Shin; Young Hoon Kim; Duck‐Jong Han; Su‐Kil Park; Seog‐Woon Kwon; Dae‐Hyun Ko
• Keywords: Immunoglobulin M

BACKGROUND Recent advances in desensitization techniques and immunosuppressive therapy have led to improved outcomes after ABO‐incompatible (ABO‐i) kidney transplantation (KT). However, questions remain unanswered, particularly regarding which type of ABO isoagglutinin—immunoglobulin M (IgM) or immunoglobulin (IgG)—is significantly involved antibody‐mediated rejection (AMR). STUDY DESIGN AND METHODS We retrospectively analyzed data from 120 patients who underwent ABO‐i KT between 2012 2014. Preoperative plasma exchange was performed until the IgM isoagglutinin titer 4 less, regardless IgG titer. Clinical were compared patient groups with pre‐KT 16 greater (high IgG; range, 16‐256; n = 39) 8 less (low −8; 81). RESULTS The median follow‐up periods 59 IgG) 55 months. Patient survival at 5 years (p 0.314) 100% 97.4% IgG). Graft 0.480) 98.7% AMR by anti‐ABO antibody occurred only one low‐IgG group. CONCLUSION Patients high titers had equally successful as those low titers. can be successfully reducing determined immediate spin tube method.