{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:35:30Z","timestamp":1784547330393,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,10,6]],"date-time":"2019-10-06T00:00:00Z","timestamp":1570320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To analyze the prevalence of systemic de novo thrombotic microangiopathy in <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content>\u2010incompatible kidney transplantation and risk factors associated with this condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 201 patients who received living\u2010donor kidney transplantation (114 patients with <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content>\u2010identical kidney transplantation and 87 patients with <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content>\u2010incompatible kidney transplantation) were retrospectively analyzed. Systemic de novo thrombotic microangiopathy was diagnosed clinically according to the presence of thrombocytopenia with microangiopathic hemolytic anemia and pathological findings of thrombotic microangiopathy. Anti\u2010A and anti\u2010B antibodies were purified from human plasma, and these antibodies\u2019 bindings to human kidney were investigated <jats:italic>in\u00a0vitro<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content>\u2010incompatible kidney transplantation was a significant risk factor of systemic de novo thrombotic microangiopathy (odds ratio 55.9, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.8\u20138.9, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) after transplantation. Multivariate logistic regression analysis showed that non\u2010use of mycophenolate mofetil, pretreatment immunoglobulin\u00a0G antibody titer \u226564\u2010fold and pretransplant immunoglobulin\u00a0M antibody titer \u226516\u2010fold were significant risk factors for systemic de novo thrombotic microangiopathy in <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content>\u2010incompatible kidney transplantation. Microvascular inflammation of 1\u2010h post\u2010transplant biopsy could be observed more frequently in thrombotic microangiopathy patients than in non\u2010thrombotic microangiopathy patients. Anti\u2010A and anti\u2010B antibodies purified from human plasma showed a strong <jats:italic>in\u00a0vitro<\/jats:italic> reaction against human kidney when the antibody titer was \u226516\u2010fold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Antibody titer should be decreased to \u226416\u2010fold until the day of <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content>\u2010incompatible kidney transplantation by desensitization therapy including mycophenolate mofetil. The 1\u2010h biopsy results might help to diagnose systemic de novo thrombotic microangiopathy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.14118","type":"journal-article","created":{"date-parts":[[2019,10,6]],"date-time":"2019-10-06T08:29:05Z","timestamp":1570350545000},"page":"1128-1137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Analysis of the prevalence of systemic de novo thrombotic microangiopathy after <scp>ABO<\/scp>\u2010incompatible kidney transplantation and the associated risk factors"],"prefix":"10.1111","volume":"26","author":[{"given":"Masayuki","family":"Tasaki","sequence":"first","affiliation":[{"name":"Division of Urology Department of Regenerative and Transplant Medicine Graduate School of Medical and Dental Sciences Niigata University Niigata 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