Liver Failure Has Higher IgG ABO Blood Group Isoagglutinin Titer than Kidney Failure

Background: In ABO-incompatible (ABOi) solid organ transplantation, the minimization and management of isoagglutinin (IA) against donor ABO antigens between before and two weeks after transplantation is important for preventing hyper-acute rejection. Several factors that can affect the IA titer have been reported. This is the first study to evaluate whether there are IA titer differences between kidney transplantation (KT) and liver transplantation (LT) recipients. Methods: Thirty-eight KT and 32 LT type O recipients, who underwent ABOi KT or LT between March 2013 and March 2018, were enrolled consecutively. The IgM IA and IgG IA titers of the LT and KT recipients at different time points (initial, operation day [day-0], postoperative one week, four weeks, and one year) were evaluated. Results: The LT recipients showed higher initial IgG IA titers than the KT recipients (P=0.01). This higher titer in the LT recipients persisted during the critical phase (from before transplantation to postoperative one week). The IgG and IgM IA titers were similar in the KT and LT recipients at postoperative four weeks. Conclusion: The difference in IA titer between the underlying diseases should be considered in the desensitization protocol before ABOi SOT. (Korean J Blood Transfus 2021;32:112-122)