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ABO Genotyping finds more A2 to B kidney transplant opportunities than lectin-based subtyping

Joseph, Abigail ; Murray, Cody J. ; Novikov, Natasha D. ; Velliquette, Randall W. ; Vege, Sunitha ; Halls, Justin B.L. ; Mah, Helen H. ; Dellagatta, Jamie L. ; Comeau, Edward and Aguad, Maria , et al. (2023) In American Journal of Transplantation 23(4). p.512-519
Abstract

ABO compatibility is important for kidney transplantation, with longer waitlist times for blood group B kidney transplant candidates. However, kidneys from non-A1 (eg, A2) subtype donors, which express less A antigen, can be safely transplanted into group B recipients. ABO subtyping is routinely performed using anti-A1 lectin, but DNA-based genotyping is also possible. Here, we compare lectin and genotyping testing. Lectin and genotype subtyping was performed on 554 group A deceased donor samples at 2 transplant laboratories. The findings were supported by 2 additional data sets of 210 group A living kidney donors and 124 samples with unclear lectin testing sent to a reference laboratory. In deceased... (More)

ABO compatibility is important for kidney transplantation, with longer waitlist times for blood group B kidney transplant candidates. However, kidneys from non-A1 (eg, A2) subtype donors, which express less A antigen, can be safely transplanted into group B recipients. ABO subtyping is routinely performed using anti-A1 lectin, but DNA-based genotyping is also possible. Here, we compare lectin and genotyping testing. Lectin and genotype subtyping was performed on 554 group A deceased donor samples at 2 transplant laboratories. The findings were supported by 2 additional data sets of 210 group A living kidney donors and 124 samples with unclear lectin testing sent to a reference laboratory. In deceased donors, genotyping found 65% more A2 donors than lectin testing, most with weak lectin reactivity, a finding supported in living donors and samples sent for reference testing. DNA sequencing and flow cytometry showed that the discordances were because of several factors, including transfusion, small variability in A antigen levels, and rare ABO∗A2.06 and ABO∗A2.16 sequences. Although lectin testing is the current standard for transplantation subtyping, genotyping is accurate and could increase A2 kidney transplant opportunities for group B candidates, a difference that should reduce group B wait times and improve transplant equity.

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type
Contribution to journal
publication status
published
subject
keywords
ABO genotyping, ABO incompatibility, Dolichos biflorus lectin, donors and donation, kidney transplantation/nephrology, molecular biology, solid organ transplantation, translational research/science
in
American Journal of Transplantation
volume
23
issue
4
pages
8 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:36732087
  • scopus:85150247533
ISSN
1600-6135
DOI
10.1016/j.ajt.2022.12.017
language
English
LU publication?
yes
id
8a59abfe-da19-4d67-bb2b-c378ad3d07bc
date added to LUP
2023-07-05 12:20:54
date last changed
2024-04-19 23:14:42
@article{8a59abfe-da19-4d67-bb2b-c378ad3d07bc,
  abstract     = {{<p>ABO compatibility is important for kidney transplantation, with longer waitlist times for blood group B kidney transplant candidates. However, kidneys from non-A<sub>1</sub> (eg, A<sub>2</sub>) subtype donors, which express less A antigen, can be safely transplanted into group B recipients. ABO subtyping is routinely performed using anti-A<sub>1</sub> lectin, but DNA-based genotyping is also possible. Here, we compare lectin and genotyping testing. Lectin and genotype subtyping was performed on 554 group A deceased donor samples at 2 transplant laboratories. The findings were supported by 2 additional data sets of 210 group A living kidney donors and 124 samples with unclear lectin testing sent to a reference laboratory. In deceased donors, genotyping found 65% more A<sub>2</sub> donors than lectin testing, most with weak lectin reactivity, a finding supported in living donors and samples sent for reference testing. DNA sequencing and flow cytometry showed that the discordances were because of several factors, including transfusion, small variability in A antigen levels, and rare ABO∗A2.06 and ABO∗A2.16 sequences. Although lectin testing is the current standard for transplantation subtyping, genotyping is accurate and could increase A<sub>2</sub> kidney transplant opportunities for group B candidates, a difference that should reduce group B wait times and improve transplant equity.</p>}},
  author       = {{Joseph, Abigail and Murray, Cody J. and Novikov, Natasha D. and Velliquette, Randall W. and Vege, Sunitha and Halls, Justin B.L. and Mah, Helen H. and Dellagatta, Jamie L. and Comeau, Edward and Aguad, Maria and Kaufman, Richard M. and Olsson, Martin L. and Guleria, Indira and Stowell, Sean R. and Milford, Edgar L. and Hult, Annika K. and Yeung, Melissa Y. and Westhoff, Connie M. and Murphey, Cathi L. and Lane, William J.}},
  issn         = {{1600-6135}},
  keywords     = {{ABO genotyping; ABO incompatibility; Dolichos biflorus lectin; donors and donation; kidney transplantation/nephrology; molecular biology; solid organ transplantation; translational research/science}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{512--519}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{American Journal of Transplantation}},
  title        = {{ABO Genotyping finds more A<sub>2</sub> to B kidney transplant opportunities than lectin-based subtyping}},
  url          = {{http://dx.doi.org/10.1016/j.ajt.2022.12.017}},
  doi          = {{10.1016/j.ajt.2022.12.017}},
  volume       = {{23}},
  year         = {{2023}},
}