Relation between ABO blood type antigen and antibody and acute vascular rejection in ABO incompatible kidney transplantation

THE CLINICAL course and pathology of acute vascular rejection (AVR) in ABO-incompatible kidney transplantation (ABOIncKTx) seems to be different from acute rejection (AR) in ABO-compatible KTx. The anti-A or B blood type antibody (Ab) may react on the blood type A or B antigen (Ag) of the renal allografts as an Ab-mediated immunologic reaction. However, the mechanism of AVR in ABOIncKTx is still unknown and there were many ABOIncKTx patients without AVR under the existence of antidonor blood type antibody. Therefore we investigated the localization of the blood type Ag in renal allografts and the sequential change of blood type Ab following pretreatment and Tx and characteristic pathologic findings of AVR in ABOIncKTx.