ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Navigating Through IgM Antibodies in Deceased Donor Kidney Transplants from A2/A2B Donors to B Recipients

M. Kueht, A. Gamilla-Crudo, S. Hussain, R. Kulkarni, J. Fair, H. Stevenson-Lerner, M. Mujtaba

University of Texas Medical Branch, Galveston, TX

Meeting: 2020 American Transplant Congress

Abstract number: 569

Keywords: Antibodies, Graft function, Induction therapy, Plasmapheresis

Session Information

Session Name: Kidney Immunosuppression: Desensitization

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

 Presentation Time: 3:27pm-3:39pm

Location: Virtual

*Purpose: Multiple studies have shown acceptable deceased donor transplant (DDT) outcomes from A2 and A2B donors into B recipients; however, concerns remain for acute rejection and thrombotic microangiopathy. Per UNOS, transplant centers interested in participating in A2/A2B to B DDT are required to define and adhere to their own acceptable IgG anti-A2 titers. There is no cut off value required for IgM. IgM is a pentamer and can be easily cleared from circulation by plasmapheresis (TPE). At our center we have a IgG anti-A2 titre cut off limit of 1:8 for a potential B recipient. Here, we share our experience.

*Methods: Since the change in renal allocation policy in December 2014, we have performed 22 DDT from A2/A2B donors into B recipients. We performed peri-operative TPE in all these patients. All patients received thymoglobulin induction (4-6 mg/kg) and are maintained on Mycophenolate Mofetil and Tacrolimus. We use a Column Agglutination Technique with and without DTT (dithiothreitol) for Isoagglutinin testing at 2 separate occasions and then acceptable titers are updated in UNOS listing every 90 days. Our patients underwent 1 session of TPE pre- and at least one post-transplant.

*Results: From 2015 to 2019, twenty two A2/A2B into B, DDT were performed. Mean recipient age was 47 years and the majority were male (89%). The mean PRA was 18.5 and the mean donor KDPI was 56. Eighty nine percent of the deceased donors were A2 and the remaining were blood type A2B. Recipient anti-A2 untreated (IgM) ranged from 1:4 to 1:32 dilution. Four patients (21%) had rejection within 30 days of TX; one patient was noted to have Thrombotic microangiopathy on biopsy, which recovered with continuation of TPE. At 1 year, median serum creatinine was 1.3 mg/dl. At mean follow up of 18 months the patient and graft survival is 100%, and 96% respectively. One kidney allograft was lost due to post biopsy bleeding.

*Conclusions: Our data indicate that A2B/A2 to B renal transplantation can be done safely from the deceased donor. The addition of TPE is effective in lowering any potential immunological complication that may occur from IgM antibodies. IgM titers should be taken into consideration when planning for such ABO “incompatible” transplantation.

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Kueht M, Gamilla-Crudo A, Hussain S, Kulkarni R, Fair J, Stevenson-Lerner H, Mujtaba M. Navigating Through IgM Antibodies in Deceased Donor Kidney Transplants from A2/A2B Donors to B Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/navigating-through-igm-antibodies-in-deceased-donor-kidney-transplants-from-a2-a2b-donors-to-b-recipients/. Accessed May 11, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences