Tasaki Masayuki, Saito Kazuhide, Takahashi Kota
Division of Urology, Department of Regenerative & Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, 1-757, Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan.
Takahashi Memorial Medical Institute, Tokyo 170-0004, Japan.
Antibodies (Basel). 2025 Sep 15;14(3):78. doi: 10.3390/antib14030078.
: The accurate evaluation of anti-ABO antibodies is essential for risk stratification in ABO-incompatible (ABOi) transplantation. Historically, hemagglutination-based titration has been the cornerstone of such an assessment; however, different tools are being evaluated in this context. In recent years, several novel methods have been reported. : A narrative review was conducted using PubMed, Scopus, and Google Scholar, focusing on recent studies evaluating anti-ABO antibody measurement techniques in the context of ABOi organ transplantation. : In addition to the conventional tube method, techniques such as column agglutination technology, flow cytometry, and enzyme-linked immunosorbent assay are utilized for anti-ABO antibody assessment. However, any particular technique, significant interinstitutional and interoperator variabilities have been reported due to differences in the detailed protocols and the inherently subjective nature of some techniques. Moreover, these assays are based on the antibody binding to ABO antigens expressed on red blood cells, which might not accurately reflect the clinical context of organ transplantation. In recent years, technological advances have enabled the development of novel assays evaluating antibody responses specifically against the ABO antigens expressed on vascular endothelial cells. These include glycan microarrays, which differentiate responses by ABO antigen subtypes, and CD31-based microarrays, wherein recombinant CD31 proteins expressing ABO antigens are immobilized. These approaches are applied to assess clinically relevant anti-ABO antibodies in the context of ABOi organ transplantation. : The objective evaluation of antibody titers against ABO antigens on vascular endothelial cells might not only enable a more accurate risk assessment but also facilitate meaningful comparisons between institutions.
准确评估抗ABO抗体对于ABO血型不相容（ABOi）移植中的风险分层至关重要。从历史上看，基于血凝的滴定一直是此类评估的基石；然而，目前正在评估不同的工具。近年来，已有数种新方法被报道。：使用PubMed、Scopus和谷歌学术进行了一项叙述性综述，重点关注近期在ABOi器官移植背景下评估抗ABO抗体测量技术的研究。：除了传统的试管法外，柱凝集技术、流式细胞术和酶联免疫吸附测定等技术也被用于抗ABO抗体评估。然而，由于详细方案的差异以及某些技术固有的主观性，已报道了任何特定技术在机构间和操作人员间存在显著差异。此外，这些检测基于抗体与红细胞上表达的ABO抗原的结合，这可能无法准确反映器官移植的临床情况。近年来，技术进步推动了新型检测方法的发展，这些方法专门评估针对血管内皮细胞上表达的ABO抗原的抗体反应。这些方法包括聚糖微阵列，它可区分ABO抗原亚型的反应，以及基于CD31的微阵列，其中固定有表达ABO抗原的重组CD31蛋白。这些方法被应用于评估ABOi器官移植背景下临床相关的抗ABO抗体。：客观评估针对血管内皮细胞上ABO抗原的抗体滴度不仅可以实现更准确的风险评估，还有助于机构间进行有意义的比较。
