{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T08:12:53Z","timestamp":1784189573119,"version":"3.55.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This study aimed to evaluate whether a 2-week period of daily isoagglutinin titer testing after ABO-incompatible kidney transplantation (ABOi-KT) is sufficient to ensure successful engraftment and to advocate for an extension of the monitoring duration in specific situations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We reviewed patients from January 2022 to December 2023 at Asan Medical Center who underwent therapeutic plasma exchange (TPE) due to elevated ABO antibody titers and suspected acute antibody-mediated rejection (AMR) after ABOi-KT. Data collected included pre- and posttransplantation laboratory results, clinical and procedural information, imaging studies, and needle biopsy results of the renal graft.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We encountered 3 cases of acute AMR 2 weeks after transplantation. All cases exhibited simultaneous increases in anti-ABO antibody isoagglutinin titers, creatinine, and C-reactive protein levels. Clinical signs, including fever, suggested possible infection, and renal graft biopsy, confirmed AMR in all cases. Two cases underwent graftectomy, while the third recovered renal function after conservative treatment, including TPE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings suggest that a 2-week monitoring period for isoagglutinin titers after ABOi-KT may not be sufficient to detect late AMR. Extending the monitoring duration and considering lifelong fresh-frozen plasma transfusion with graft-compatible blood types, along with periodic isoagglutinin titer testing in cases of suspected AMR, may improve long-term graft outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqae122","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T17:16:01Z","timestamp":1725988561000},"page":"290-297","source":"Crossref","is-referenced-by-count":5,"title":["Long-term isoagglutinin monitoring after ABO-incompatible kidney transplantation"],"prefix":"10.1093","volume":"163","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0088-0488","authenticated-orcid":false,"given":"Han Joo","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5197-6340","authenticated-orcid":false,"given":"Yousun","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Kangdong Sacred Heart Hospital , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyungsuk","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Seoul National University Hospital , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youngmin","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Hyun","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heung-Bum","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9781-0928","authenticated-orcid":false,"given":"Dae-Hyun","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"issue":"6","key":"2025021323430464600_CIT0001","first-page":"4538","article-title":"Present experiences in a series of 26 ABO-incompatible living donor renal allografts","volume":"19","author":"Alexandre","year":"1987","journal-title":"Transplant Proc."},{"issue":"1","key":"2025021323430464600_CIT0002","doi-asserted-by":"publisher","first-page":"18","DOI":"10.5500\/wjt.v4.i1.18","article-title":"ABO incompatible renal transplants: good or bad","volume":"4","author":"Muramatsu","year":"2014","journal-title":"World J Transplant"},{"key":"2025021323430464600_CIT0003","author":"Annual report of the transplant","year":"2021"},{"issue":"1","key":"2025021323430464600_CIT0004","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1053\/j.ajkd.2019.04.025","article-title":"Transplanting the untransplantable","volume":"75","author":"Holscher","year":"2020","journal-title":"Am J Kidney Dis."},{"key":"2025021323430464600_CIT0005","doi-asserted-by":"publisher","first-page":"101899","DOI":"10.1016\/j.trim.2023.101899","article-title":"Advancement in preoperative desensitization therapy for ABO incompatible kidney transplantation recipients","volume":"80","author":"Ma","year":"2023","journal-title":"Transpl Immunol."},{"issue":"7","key":"2025021323430464600_CIT0006","doi-asserted-by":"publisher","first-page":"191","DOI":"10.5500\/wjt.v10.i7.191","article-title":"Current protocols and outcomes of ABO-incompatible kidney transplantation","volume":"10","author":"Salvadori","year":"2020","journal-title":"World J Transplant"},{"issue":"1","key":"2025021323430464600_CIT0007","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1111\/iju.14109","article-title":"Latest insights on ABO-incompatible living-donor renal transplantation","volume":"27","author":"Uchida","year":"2020","journal-title":"Int J Urol."},{"issue":"9","key":"2025021323430464600_CIT0008","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1097\/00007890-200011150-00011","article-title":"Role of anti-A\/B antibody titers in results of ABO-incompatible kidney transplantation","volume":"70","author":"Shimmura","year":"2000","journal-title":"Transplantation."},{"issue":"5","key":"2025021323430464600_CIT0009","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.1111\/j.1600-6143.2010.03103.x","article-title":"ABO antibody titer and risk of antibody-mediated rejection in ABO-incompatible renal transplantation","volume":"10","author":"Tobian","year":"2010","journal-title":"Am J Transplant."},{"issue":"2","key":"2025021323430464600_CIT0010","doi-asserted-by":"publisher","first-page":"99","DOI":"10.4285\/kjt.22.0011","article-title":"Laboratory support of ABO antibody monitoring for ABO-incompatible solid organ transplantation","volume":"36","author":"Chung","year":"2022","journal-title":"Korean J Transplant"},{"issue":"3","key":"2025021323430464600_CIT0011","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1111\/trf.15672","article-title":"ABO-incompatible kidney transplantation can be successfully conducted by monitoring IgM isoagglutinin titers during desensitization","volume":"60","author":"Kim","year":"2020","journal-title":"Transfusion."},{"issue":"6","key":"2025021323430464600_CIT0012","doi-asserted-by":"publisher","first-page":"103786","DOI":"10.1016\/j.transci.2023.103786","article-title":"Clinical significance of IgM and IgG isoagglutinins in ABO-incompatible solid organ transplantation: insights from materno-fetal immunoglobulin status","volume":"62","author":"Kim","year":"2023","journal-title":"Transfus Apher Sci."},{"issue":"9","key":"2025021323430464600_CIT0013","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1111\/tri.12969","article-title":"Outcomes and risk stratification for late antibody-mediated rejection in recipients of ABO-incompatible kidney transplants: a retrospective study","volume":"30","author":"Lonze","year":"2017","journal-title":"Transpl Int."},{"issue":"1","key":"2025021323430464600_CIT0014","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2369-15-97","article-title":"Late antibody-mediated rejection after ABO-incompatible kidney transplantation during Gram-negative sepsis","volume":"15","author":"de Weerd","year":"2014","journal-title":"BMC Nephrol."},{"issue":"6","key":"2025021323430464600_CIT0015","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1111\/nep.13412","article-title":"Clinical significance of isoagglutinin titre with the current desensitization protocol in ABO-incompatible kidney transplantation","volume":"24","author":"Baek","year":"2019","journal-title":"Nephrology (Carlton)"},{"key":"2025021323430464600_CIT0016","volume-title":"Technical Manual","author":"Cohn","year":"2023","edition":"21"},{"issue":"1","key":"2025021323430464600_CIT0017","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.humimm.2022.08.001","article-title":"Accommodation in allogeneic and xenogeneic organ transplantation: prevalence, impact, and implications for monitoring and for therapeutics","volume":"84","author":"Platt","year":"2023","journal-title":"Hum Immunol."},{"issue":"2","key":"2025021323430464600_CIT0018","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1007\/s10157-007-0461-z","article-title":"Recent findings in ABO-incompatible kidney transplantation: classification and therapeutic strategy for acute antibody-mediated rejection due to ABO-blood-group-related antigens during the critical period preceding the establishment of accommodation","volume":"11","author":"Takahashi","year":"2007","journal-title":"Clin Exp Nephrol."},{"issue":"3","key":"2025021323430464600_CIT0019","doi-asserted-by":"publisher","first-page":"e12418","DOI":"10.1111\/xen.12418","article-title":"Accommodation in ABO-incompatible organ transplants","volume":"25","author":"Garcia de Mattos Barbosa","year":"2018","journal-title":"Xenotransplantation"},{"issue":"4","key":"2025021323430464600_CIT0020","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1097\/MOT.0b013e3283636c20","article-title":"Kidney transplantation across HLA and ABO antibody barriers","volume":"18","author":"Becker","year":"2013","journal-title":"Curr Opin Organ Transplant"},{"issue":"1","key":"2025021323430464600_CIT0021","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1111\/bjh.15167","article-title":"British Society of Haematology Guidelines on the spectrum of fresh frozen plasma and cryoprecipitate products: their handling and use in various patient groups in the absence of major bleeding","volume":"181","author":"Green","year":"2018","journal-title":"Br J Haematol."},{"issue":"10185","key":"2025021323430464600_CIT0022","doi-asserted-by":"publisher","first-page":"2059","DOI":"10.1016\/S0140-6736(18)32091-9","article-title":"Clinical outcomes after ABO-incompatible renal transplantation: a systematic review and meta-analysis","volume":"393","author":"Scurt","year":"2019","journal-title":"Lancet."},{"issue":"2","key":"2025021323430464600_CIT0023","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/S0140-6736(19)31000-4","article-title":"Origin of naturally occurring hemagglutinins and hemolysins: a review","volume":"66","author":"Wiener","year":"1951","journal-title":"J Immunol."},{"issue":"7","key":"2025021323430464600_CIT0024","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1172\/JCI106094","article-title":"Blood group isoantibody stimulation in man by feeding blood group-active bacteria","volume":"48","author":"Springer","year":"1969","journal-title":"J Clin Invest."},{"issue":"3","key":"2025021323430464600_CIT0025","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1093\/infdis\/133.3.329","article-title":"Relation of infection with Neisseria gonorrhoeae to ABO blood groups","volume":"133","author":"Foster","year":"1976","journal-title":"J Infect Dis."},{"issue":"4","key":"2025021323430464600_CIT0026","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1038\/s41435-020-0105-9","article-title":"Emergence and significance of carbohydrate-specific antibodies","volume":"21","author":"Kappler","year":"2020","journal-title":"Genes Immun."},{"issue":"7","key":"2025021323430464600_CIT0027","doi-asserted-by":"publisher","first-page":"2040","DOI":"10.1021\/ja045021y","article-title":"Escherichia coli O86 O-antigen biosynthetic gene cluster and stepwise enzymatic synthesis of human blood group B antigen tetrasaccharide","volume":"127","author":"Yi","year":"2005","journal-title":"J Am Chem Soc."},{"issue":"3","key":"2025021323430464600_CIT0028","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1128\/iai.15.3.713-719.1977","article-title":"Neisseria gonorrhoeae and ABO isohemagglutinins","volume":"15","author":"Miler","year":"1977","journal-title":"Infect Immun."},{"issue":"6","key":"2025021323430464600_CIT0029","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1084\/jem.113.6.1077","article-title":"Blood group activity of gram-negative bacteria","volume":"113","author":"Springer","year":"1961","journal-title":"J Exp Med."},{"issue":"2","key":"2025021323430464600_CIT0030","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s00467-012-2302-x","article-title":"Bleeding complications in pediatric ABO-incompatible kidney transplantation","volume":"28","author":"Schaefer","year":"2013","journal-title":"Pediatr Nephrol."},{"issue":"4","key":"2025021323430464600_CIT0031","doi-asserted-by":"publisher","first-page":"266","DOI":"10.4103\/0019-5049.155016","article-title":"Blood transfusion practices in liver transplantation","volume":"59","author":"Das","year":"2015","journal-title":"Indian J Anaesth."},{"key":"2025021323430464600_CIT0032","article-title":"Australian and New Zealand Society of Blood Transfusion Limited","author":"Guidelines for Transfusion and Immunohaematology Laboratory Practice: Revised January 2020"},{"issue":"1","key":"2025021323430464600_CIT0033","doi-asserted-by":"publisher","first-page":"70","DOI":"10.17945\/kjbt.2020.31.1.70","article-title":"Transfusion in ABO-incompatible solid organ transplantation","volume":"31","author":"Kim","year":"2020","journal-title":"Korean J Blood Transfus"},{"issue":"1","key":"2025021323430464600_CIT0034","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3343\/alm.2022.42.1.105","article-title":"of ABO group for blood component transfusion in ABO-incompatible solid organ transplantation: a questionnaire survey in Korea and guideline proposal","volume":"42","author":"Chung","year":"2022","journal-title":"Ann Lab Med"}],"container-title":["American Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/163\/2\/290\/59076333\/aqae122.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/163\/2\/290\/59076333\/aqae122.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T23:43:12Z","timestamp":1739490192000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajcp\/article\/163\/2\/290\/7754710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,10]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,9,10]]},"published-print":{"date-parts":[[2025,2,12]]}},"URL":"https:\/\/doi.org\/10.1093\/ajcp\/aqae122","relation":{},"ISSN":["0002-9173","1943-7722"],"issn-type":[{"value":"0002-9173","type":"print"},{"value":"1943-7722","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2024,9,10]]}}}