The Potential Significance of ABO Genotyping for Donor Selection in Kidney Transplantation

Y. Zhou¹, W. Deng¹, Y. Wang¹, N. Cui¹, Y. Wu¹, J. Xu¹, S. Fu¹, L. Xiao¹, H. Liu¹, F. Xiong², Y. Miao¹

¹Department of Organ Trasplantation, Nanfang Hospital, Guangzhou, China, ²Southern Medical University, Guangzhou, China

Meeting: 2020 American Transplant Congress

Abstract number: D-020

Keywords: Alloantigens, Allocation, Rejection, Waiting lists

Session Information

Session Name: Poster Session D: Kidney Deceased Donor Selection

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: The ABO blood group system is clinically important in kidney transplantation, but ABO genotyping fails to attract sufficient attention in China. We identified one case of early graft dysfunction due to an ABO genotype mismatch. Here, we performed ABO genotyping in blood samples, analyzed grouping discrepancies, and investigated the weak A subgroup frequency in kidney transplantation candidates.

*Methods: Blood samples from 302 uremic patients with grouping discrepancies and 356 uremic patients with type A blood were analyzed using standard serologic serotyping techniques. The ABO genotypes and alleles were analyzed by polymerase chain reaction sequence-specific primer (PCR-SSP) and sequence-based typing (PCR-SBT).

*Results: All 302 candidates carried weak ABO subgroup alleles and 77.48% carried irregular ABO antibodies. The discrepancy rate between serotyping and genotyping was 42.38%, and the mismatching rate of donor selection according to serotype reached 88.74%. In addition, 2.53% of kidney transplantation candidates in blood type A were determined to be in the weak A subgroup. This was a higher percentage than that observed in the healthy Chinese population (0.53%), but much lower than that observed in Caucasians (20%). This suggested that these candidates should receive an A1 graft, whereas due to rareness, the A2 graft could not serve as the alternative for O and B candidates as it did in America and Europe.

*Conclusions: We revealed the high risk of blood type misjudgment and genetically ABO-mismatched transplantation based on serological testing. Improved precision of ABO genotyping is crucial for successful kidney transplantation.

To cite this abstract in AMA style:

Zhou Y, Deng W, Wang Y, Cui N, Wu Y, Xu J, Fu S, Xiao L, Liu H, Xiong F, Miao Y. The Potential Significance of ABO Genotyping for Donor Selection in Kidney Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-potential-significance-of-abo-genotyping-for-donor-selection-in-kidney-transplantation/. Accessed May 11, 2025.

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