02274nas a2200169   4500008004100000020001400041024001700055245008800072210006900160260011600229300001300345490000700358520165500365100002002020700001902040856004502059       2015                        eng d  a1399-0012  abb5, 871024000aTransplantation of ABO A2 kidneys into O recipients: do IgM anti-A1 titers matter?.0 aTransplantation of ABO A2 kidneys into O recipients do IgM antiA  aDenmarkbTierney,Joshua. Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.c2015  a379 - 820 v293 aBACKGROUND: The ABO blood subgroup A2 expresses lower levels of A antigen on the cell surface and is less immunogenic toward anti-A immunoglobulin present in blood type O or B recipients. Previous studies have shown successful kidney transplantation from A2 donors into O or B recipients with low pre-transplant anti-A titers. Previous studies suggest good results with recipient IgG titers <1:8. Few studies have specifically evaluated the importance of anti-A1 IgM titers on early outcomes following A2 to O or B kidney transplantation., METHODS: We performed a single center, retrospective review of all A2 to O living donor kidney transplants. All recipients had pre-transplant anti-A IgG titers <1:8. IgM titers were measured in all recipients and were reported but not used to determine eligibility for transplant., RESULTS: From 2001 to 2013, we performed seven consecutive A2 to O living donor kidney transplants. Early allograft dysfunction, acute rejection or thrombotic microangiopathy, occurred in four patients and were associated with high IgM titers despite low IgG titers., CONCLUSIONS: Our data show a high incidence of early acute rejection or thrombotic microangiopathy in A2 to O kidney transplants with high recipient anti-A IgM titers despite low IgG titers. Steps to lower anti-IgM pre-transplant may reduce the risk of early allograft dysfunction in A2 to O or B kidney transplants. Attention should be paid to IgM titers in establishing individual center selection criteria for A2 to B kidney transplants under the new UNOS kidney allocation system.Copyright © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.1 aTierney, Joshua1 aShaffer, David  uhttp://613633.bywedr.asia/reference/4419