Status:
Ready to upload
Record number:
1594
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Case reports. Unknown role of IgM anti-A1 titers.
Time to detection:
2-16 days (mean: 7days)
Alerting signals, symptoms, evidence of occurrence:
Early allograft dysfunction with acute rejection or thrombotic microangiopathy or both after transplantation of kidneys from recipients that are blood group A2 into blood group O recipients with anti-A1 IgG titres less than 1:8.
Demonstration of imputability or root cause:
Retrospective analysis of seven transplants of A2 donor into O recipient. All recipients had anti-A1 IgG titer less than 1:8. IgM titers were not considered in the donor selection. Retrospective analysis demonstrates that 4/7 recipients had early allograft dysfuction which were treated and subsequently had good allograft function. There was no prospective anti-A1 titer monitoring post-transplant. So this may provide data that IgM titers may be useful, however a prospective study can provide definite evidence
Imputability grade:
2 Probable
Groups audience:
Keywords:
Suggest new keywords:
Kidney transplant
Blood group A2 to O
IgG anti-A titres
IgM anti-A titres
Rejection
Reference attachment:
Suggest references:
Tierney J, Shaffer D. Transplantation of ABO A2 kidneys into O recipients: do IgM anti-A1 titers matter? Clin Transplant. 2015 Apr;29(4):379-82
Expert comments for publication:
This study adds to the debate of clinical utility of IgM anti-A1 titres in blood group O or B recipients when transplanting solid organs from blood group A2. While many centers only use IgG anti-A1 titers to proceed with transplantation, some centers use both IgG and IgM titres to proceed. Authors rightfully point out that this is retrospective study where no post-transplant monitoring of anti-A1 titers was performed. Studies have demonstrated the need for post-transplant monitoring of titres and early intervention in case of rising titres.