Fadeyi Emmanuel A, Stratta Robert J, Farney Alan C, Pomper Gregory J
From the Departments of Pathology
Surgery, Wake Forest University School of Medicine, Winston-Salem, NC.
Am J Clin Pathol. 2016 Aug;146(2):268-71. doi: 10.1093/ajcp/aqw101.
Transplantation of the blood group A2B in a recipient was successfully performed in the setting of receiving a deceased donor kidney from an "incompatible" A1B donor.
The donor and recipient were both typed for ABO blood group, including ABO genotyping. The donor and recipient were tested for ABO, non-ABO, and human leukocyte antigen (HLA) antibodies. The donor and recipient were typed for HLA antigens, including T- and B-flow cytometry crossmatch tests.
The recipient's RBCs were negative with A1 lectin, and immunoglobulin G anti-A1 was demonstrated in the recipient's plasma. The donor-recipient pair was a four-antigen HLA mismatch, but final T- and B-flow cytometry crossmatch tests were compatible. The transplant procedure was uneventful; the patient experienced immediate graft function with no episodes of rejection or readmissions more than 2 years later.
It may be safe to transplant across the A1/A2 blood group AB mismatch barrier in the setting of low titer anti-A1 isoagglutinins without the need for pretransplant desensitization even if the antibody produced reacts with anti-human globulin.
在接受来自“A1B”不相合的已故供体肾脏的情况下，成功地将A2B血型的肾脏移植给了受者。
对供体和受者进行ABO血型分型，包括ABO基因分型。对供体和受者进行ABO、非ABO和人类白细胞抗原（HLA）抗体检测。对供体和受者进行HLA抗原分型，包括T细胞和B细胞流式细胞术交叉配型试验。
受者红细胞与A1凝集素反应阴性，且在受者血浆中检测到免疫球蛋白G抗A1。供受者对为四抗原HLA错配，但最终的T细胞和B细胞流式细胞术交叉配型试验结果相合。移植手术过程顺利；患者移植后立即肾功能恢复，2年多来未发生排斥反应或再次入院情况。
在低滴度抗A1同种凝集素的情况下，跨越A1/A2血型AB错配屏障进行移植可能是安全的，即使产生的抗体与抗人球蛋白反应，也无需移植前脱敏。
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