{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:53:51Z","timestamp":1790369631720,"version":"4.1.0"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,2,26]],"date-time":"2015-02-26T00:00:00Z","timestamp":1424908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content> blood subgroup A2 expresses lower levels of A antigen on the cell surface and is less immunogenic toward anti\u2010A immunoglobulin present in blood type O or B recipients. Previous studies have shown successful kidney transplantation from A2 donors into O or B recipients with low pre\u2010transplant anti\u2010A titers. Previous studies suggest good results with recipient IgG titers &lt;1:8. Few studies have specifically evaluated the importance of anti\u2010A1 IgM titers on early outcomes following A2 to O or B kidney transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a single center, retrospective review of all A2 to O living donor kidney transplants. All recipients had pre\u2010transplant anti\u2010A IgG titers &lt;1:8. IgM titers were measured in all recipients and were reported but not used to determine eligibility for transplant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2001 to 2013, we performed seven consecutive A2 to O living donor kidney transplants. Early allograft dysfunction, acute rejection or thrombotic microangiopathy, occurred in four patients and were associated with high IgM titers despite low IgG titers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data show a high incidence of early acute rejection or thrombotic microangiopathy in A2 to O kidney transplants with high recipient anti\u2010A IgM titers despite low IgG titers. Steps to lower anti\u2010IgM pre\u2010transplant may reduce the risk of early allograft dysfunction in A2 to O or B kidney transplants. Attention should be paid to IgM titers in establishing individual center selection criteria for A2 to B kidney transplants under the new <jats:styled-content style=\"fixed-case\">UNOS<\/jats:styled-content> kidney allocation system.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.12527","type":"journal-article","created":{"date-parts":[[2015,2,7]],"date-time":"2015-02-07T13:24:52Z","timestamp":1423315492000},"page":"379-382","source":"Crossref","is-referenced-by-count":22,"title":["Transplantation of <scp>ABO<\/scp> A2 kidneys into O recipients: do IgM anti\u2010A1 titers matter?"],"prefix":"10.1111","volume":"29","author":[{"given":"Joshua","family":"Tierney","sequence":"first","affiliation":[{"name":"Department of Surgery Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Department of Surgery Vanderbilt University Medical Center Nashville TN USA"},{"name":"Division of Kidney and Pancreas Transplantation Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000231697.15817.51"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-198607000-00021"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(01)02433-2"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000058226.39732.32"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.2001.001003296.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000164288.82238.52"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)81197-3"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199801270-00020"},{"key":"e_1_2_6_10_1","unstructured":"www.UNOS.org UNOS policy 3.5.5.4"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2004.08.082"},{"key":"e_1_2_6_12_1","first-page":"1580","article-title":"Accelerated acute rejection of an A2 renal allograft in an O recipient: association with an increase in anti\u2010A2 antibodies","volume":"56","author":"Hanto DW","year":"1993","journal-title":"Transplantation"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fctr.12527","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.12527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T13:38:55Z","timestamp":1695562735000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.12527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,26]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,4]]}},"alternative-id":["10.1111\/ctr.12527"],"URL":"https:\/\/doi.org\/10.1111\/ctr.12527","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,26]]}}}