2014 Volume 2 Issue 1 Pages 62-67
【Objective】We studied the relationship between antibody titer before desensitization (ABOab) and the incidence of acute antibody-mediated rejection (AMR) in ABO-incompatible kidney transplantation (ABOiKTx). 【Methods】Fifteenfive ABOiKTx recipients (B to A：11, AB to A：7, A to B：9, AB to B：1, A to O：14, B to O：9, AB to O：3) were enrolled in this study. Preconditioning for removal of ABOab was comprised of tacrolimus, mycophenolatemofetile, corticosteroid, rituximab and some sessions of plasmapheresis. We first compared the baseline ABOab and rebound phenomenon, which defined by the double elevation from that in previous day. Second, the base line ABOab and consequent incidence of AMR were also compared. 【Results】The average baseline ABOab was 4 (range 2 ～ 16) among blood type A (anti-B), was 2 (range 2 ～ 32) among blood type B (anti-A), was 32 (range 16 ～ 256) among blood type O (anti-A) and was 16 (range 16 ～ 128) and among blood type O (anti-B). Baseline ABOaband rebound were higher in blood type O than in other blood types (p＜0.01). Eight patients (14.5％) experienced AMR. The frequency of AMR was higher among patients with baseline titer of ≥ 64 (p＜0.01). 【Conclusion】High-baseline ABOab stronger than 64, which are more frequently observed in blood type Oare potent to rebound from preconditioning and high risk of AMR in ABOiKTx. Then, more sophisticated preconditioning should be required in such recipients for safer ABOiKx.
