Accommodation in ABO Incompatible Kidney Transplantation

ABO-incompatible kidney transplantation carries the image of pronounced hyperacute rejection. However, with modern immunosuppressive therapy, humoral rejection ceases to occur after accommodation has been established. This book aims to break down fixed thinking and prejudices regarded as fact in relation to ABO-incompatible kidney transplantation.

As these data are provided as a common resource for physicians performing transplantation procedures, it has encouraged more widespread implementation of organ transplantation.

Preface. Personal History. 1. History. Acknowledgements. References. 2. Current status of treatment for chronic renal failure and factors behind increasing use of ABO-incompatible kidney transplantation in Japan. Acknowledgements. References. 3. Indications and considerations. 3.1 Indications. 3.2 Crossmatch test. 3.3 Anti-A/anti-B (anti-A, anti-B, and anti-AB) antibodies. 3.4 Age and dialysis history. 3.5 Infection/ 3.6 Anticoagulation therapy. 3.7 Informed consent. Acknowledgements. References. 4. Blood group antigens, histo-blood group antigens, and their antibodies. 4.1 Differences between blood group antigens and histo-blood group antigens. 4.2 ABO(H) blood group gene, blood group glycosyltransferase (a gene product), and blood group antigens. 4.3 Distribution of ABO blood group antigens throughout the body and within the kidneys 4.4 Measuring anti-A and -B antibodies. 4.5 Origin of ABO blood group glycosyltransferase. 4.6 ABO blood group antigens and other blood group antigens. 4.7 Lymphocyte crossmatch test and vascular endothelial cell crossmatch test. 4.8 The role of ABO blood group antigens and HLA antigens in bone marrow transplants and organ transplants. Acknowledgements. References. 5. Rejection. 5.1 Considerations regarding rejection mechanism. 5.2 Mechanism and classification of rejection in ABO-incompatible kidney transplantation. Acknowledgements. References. 6. Accommodation in ABO-incompatible kidney transplantation - why do kidney grafts survive. 6.1 Carbohydrate blood group substances and ABO blood group antigens on erythrocytes. 6.2 ABO(H) blood group gene, blood group glycosyltransferase (products of these genes), and blood group antigens. 6.3 Formation of ABO glycosyltransferase. 6.4 Inhibitors and antibodies to ABO glycosyltransferase, and antibodies to ABO blood group antigens. 6.5 The role of ABO blood group antigens and the HLA antigen system in bone marrow transplantation and organ transplantation. 6.6 Organ transplantation and ischemic time. 6.7 Definition of the terms hyperacu