Kristian Assing1, Ulrik Sprogoe2, Christian Nielsen2, Mads Rasmussen2, Mark Yazer2,3, Claus Bistrup4. 1. Department of Clinical Immunology, Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense C, Denmark. kristian.assing@rsyd.dk. 2. Department of Clinical Immunology, Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense C, Denmark. 3. Department of Pathology, Institute for Transfusion Medicine, University of Pittsburgh, Pittsburgh, USA. 4. Department of Nephrology, Odense University Hospital, Odense, Denmark.
Abstract
BACKGROUND: Prior to an ABO incompatible kidney transplantation it is important to know the recipient's pre-transplantation anti-A and/or anti-B (isoagglutinin) titer. This study determined if pre-transplantation isoagglutinin titers remained stable, over a period of 1 year, among hemodialysis patients. METHOD: Blood was collected four times, every 3 months from 54 hemodialysis patients (hemodialysed trice per week ≥ 6 months), and 56 healthy volunteers. Measurement of anti-A and anti-B (IgM and IgG) titers were performed on an automated solid phase analyzer. The titers were converted to log2 titer steps (e.g., titer 32 = titer step 5). RESULTS: Within blood group O, mean IgG anti-A and anti-B titers were significantly higher in the hemodialysis patients (n = 22, mean titer step: anti-A: 6.4 and anti-B:4.9), compared to the healthy volunteers [n = 19, mean titer step: anti-A: 4.9 and anti-B:3.5, p = 0.02 (anti-A) and p = 0.03 (anti-B)], despite blood group O hemodialysis patients having significantly lower total plasma IgG levels (median 8.1 g/L) than healthy volunteers (11.1 g/L, p = 0.001). Neither age, nor gender determined IgG anti-A or anti-B titers. In hemodialysis patients and healthy volunteers, the upper 95% confidence limit of anti-A and anti-B titer variation (IgM and IgG) during 1 year, did not exceed 1.0 titer step in any of the ABO groups. CONCLUSIONS: Anti-A and -B titers (IgM and IgG) remained stable in both the hemodialysis patients and healthy volunteers over a period of approximately 1 year. Blood group O hemodialysis patients had, despite lower total IgG levels, significantly elevated IgG anti-A and -B titers.
BACKGROUND: Prior to an ABO incompatible kidney transplantation it is important to know the recipient's pre-transplantation anti-A and/or anti-B (isoagglutinin) titer. This study determined if pre-transplantation isoagglutinin titers remained stable, over a period of 1 year, among hemodialysis patients. METHOD: Blood was collected four times, every 3 months from 54 hemodialysis patients (hemodialysed trice per week ≥ 6 months), and 56 healthy volunteers. Measurement of anti-A and anti-B (IgM and IgG) titers were performed on an automated solid phase analyzer. The titers were converted to log2 titer steps (e.g., titer 32 = titer step 5). RESULTS: Within blood group O, mean IgG anti-A and anti-B titers were significantly higher in the hemodialysis patients (n = 22, mean titer step: anti-A: 6.4 and anti-B:4.9), compared to the healthy volunteers [n = 19, mean titer step: anti-A: 4.9 and anti-B:3.5, p = 0.02 (anti-A) and p = 0.03 (anti-B)], despite blood group O hemodialysis patients having significantly lower total plasma IgG levels (median 8.1 g/L) than healthy volunteers (11.1 g/L, p = 0.001). Neither age, nor gender determined IgG anti-A or anti-B titers. In hemodialysis patients and healthy volunteers, the upper 95% confidence limit of anti-A and anti-B titer variation (IgM and IgG) during 1 year, did not exceed 1.0 titer step in any of the ABO groups. CONCLUSIONS: Anti-A and -B titers (IgM and IgG) remained stable in both the hemodialysis patients and healthy volunteers over a period of approximately 1 year. Blood group O hemodialysis patients had, despite lower total IgG levels, significantly elevated IgG anti-A and -B titers.
Entities:
Keywords:
Dynamics; Hemodialysis; Isoagglutinins; Memory B cells; Titers
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