A Case of ABO-Incompatible Kidney Transplantation for a False-Positive T and B-Cell Crossmatch Test Due to Anti-A Antibodies

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-02-26 DOI:10.1016/j.transproceed.2025.02.013

Masahiro Ikeda , Masayuki Tasaki , Hiroki Hashiguchi , Hitomi Kanamoto , Tsutomu Anraku , Kaede Hiruma , Tatsuro Sanami , Kazuhide Saito , Yoshihiko Tomita

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引用次数: 0

Abstract

The recipient was a 50-year-old man with blood type O who was referred to our department for a pre-emptive ABO-incompatible kidney transplantation (KTx), with his wife as the donor whose blood was type A. However, both of the T and B cell complement-dependent crossmatch and flow cytometric crossmatch tests showed positive results. Even though donor-specific antibodies were negative by Luminex, we did not recommend transplantation and he had received dialysis therapy for 3 years. We conducted a re-evaluation of crossmatch tests. IgM and anti-B antibody were eliminated from the recipient's sera by the processing with dithiothreitol and the absorption mixing type B red blood cells. However, crossmatch tests still showed positive. Then, we eliminated anti-A antibody by the absorption mixing type A red blood cells. T- and B-cell crossmatch tests turned to negative, suggesting anti-A antibody in the recipient's sera binds to type A substance onto the donor's T and B lymphocytes. The recipient received an ABO-incompatible KTx with our standard desensitization therapy. Immediate graft function was achieved without any rejection

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abo血型不相容肾移植因抗A抗体导致T细胞和b细胞交叉配型试验假阳性1例。

患者为一名50岁的O型血男性，以其a型血的妻子为供体，来我科进行abo血型不相容肾移植（KTx）手术。然而，T、B细胞补体依赖性交叉配型和流式细胞仪交叉配型均为阳性结果。尽管Luminex的供体特异性抗体呈阴性，但我们不建议移植，他接受了3年的透析治疗。我们重新评估了交叉匹配试验。经二硫苏糖醇处理和B型红细胞混合吸收，消除受体血清中的IgM和抗B抗体。但交叉配型测试仍呈阳性。然后，我们通过吸收混合A型红细胞消除抗A抗体。T细胞和B细胞交叉配型测试结果为阴性，表明受体血清中的抗A抗体与供体T淋巴细胞和B淋巴细胞上的A型物质结合。接受者接受abo血型不相容的KTx和我们的标准脱敏治疗。移植后立即恢复功能，无排斥反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.