Related Experiment Video
Updated: Sep 9, 2025
18:48
In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
Published on: August 12, 2017
14.5K
Laboratory approaches in desensitization for ABO-incompatible transplantation
Kyung-Hwa Shin1,2, Hyun-Ji Lee1,3
1Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea.
Clinical Transplantation and Research
|September 5, 2025
Summary
ABO-incompatible transplants are now possible due to better immunosuppression. Accurate anti-ABO isoagglutinin titer measurement and reduction are key to preventing antibody-mediated rejection and ensuring transplant success.
Area of Science:
- Transplantation immunology
- Clinical laboratory science
- Immunosuppression strategies
Background:
- ABO-incompatible transplantation was historically contraindicated due to hyperacute rejection risks.
- Advances in immunosuppression and desensitization have made ABO-incompatible transplantation feasible.
- Accurate anti-ABO isoagglutinin titer measurement is critical for successful outcomes.
Purpose of the Study:
- To review the principles of hemagglutination and isoagglutinin titer measurement.
- To discuss the clinical significance of isoagglutinin rebound and its link to rejection.
- To highlight ongoing efforts in laboratory standardization for ABO-incompatible transplantation.
Main Methods:
- Review of hemagglutination principles and isoagglutinin titer measurement techniques.
- Analysis of factors influencing agglutination sensitivity.
- Discussion of desensitization protocols and emerging therapeutic agents.
Main Results:
- High pretransplant isoagglutinin titers (≥1:32) are strongly associated with antibody-mediated rejection (AMR).
- Posttransplant isoagglutinin rebound is a significant risk factor for AMR, especially in liver and kidney recipients.
- Various desensitization strategies, including rituximab, plasmapheresis, and novel agents, are employed.
Conclusions:
- Effective management of anti-ABO isoagglutinin titers is paramount for ABO-incompatible transplantation success.
- Careful monitoring for isoagglutinin rebound is essential post-transplant to mitigate AMR risk.
- Continued research and standardization are needed to optimize laboratory and clinical practices.
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