It has been widely believed that it is critical to remove as much anti A/B blood group antibody as possible before ABO incompatible renal transplantation (ABOI-RTx) for renal graft survival. We, however, report a rare case that implied a presence of hyperacute rejection in ABOI-RTx leading to graft loss, in a way, regardless of titers of blood group antibody before transplantation.
We newly developed a method for measuring a complement-fixing ability of anti A/B blood group IgG antibody to elucidate an immunological mechanism of how anti A/B blood group antibody works in ABOI-RTx. Results of such measurements revealed that a high positive rate of complement-fixing ability of anti A/B IgG antibody was predictive of poor graft survival or graft loss. This method, therefore, might turn out to be an important laboratory test before ABOI-RTx.

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