Blood Group A Isoagglutinins in A2→ O Simultaneous Liver/Kidney Transplantation May Not Influence Kidney Function

We simultaneously transplanted a liver and kidney (SLK) into a 55-year-old woman with end-stage liver disease secondary to recurrent primary biliary cirrhosis. The patient was blood group O, the donor was A2 (A, non-A1) and the patient's A isoagglutinin titer was 512. Good renal function was evident by normalization of her creatinine values following transplantation. Recovery was unremarkable and she was discharged on post op day 9. The patient has not experienced an episode of rejection in either organ during the 6 months of follow-up. This case is important because high A IgG isoagglutinin levels (8 or higher) in kidney alone A2 O transplantation are detrimental to outcome but do not affect outcome in liver alone A2 O transplants; however, no such anti-A titer data have been published for A2 O (or B) SLK transplantation.