Korean J Transplant.  2022 Nov;36(Supple 1):S126. 10.4285/ATW2022.F-2489.

Impact of high IgG titer in ABO-incompatible kidney transplant

• Ko Y
• Kwon HE
• Shin S
• Kim YH
• Kwon H

• KMID: 2535642
• DOI: http://doi.org/10.4285/ATW2022.F-2489

Abstract

Background
In antibody mediated rejection in ABO-incompatible kidney transplantation (KT), it was demonstrated that an-ti-ABO IgG response was more important than the IgM response. This study aims to prove the safety of transplantation of re-cipient with high IgG titer by comparing graft survival and biopsy proven acute rejection in low IgG titer (≤512) and high IgG titer (>512) group.
Methods
This retrospective observational study included O+ recipient who received ABO incompatible kidney transplantation between Jun 2018 and Dec 2020 in Asan medical center. A total of 89 patients were divided into a low IgG titer (≤512) and a high IgG titer (>512) group.
Results
Lever of preoperative IgG was higher in high IgG group (17.95 vs. 25.83, P<0.001). Number of preoperative plasmapher-esis was more in high IgG group than in low IgG group (6.56 vs. 3.76, P<0.001). Number of ABDR mismatch and DR mismatch is more in high IgG group than in low IgG group (3 vs. 4.04, 1 vs. 1.42; P=0.004). Kaplan-Meier curve shows 1-year rejection free survival (low IgG group 95.2% vs. high IgG group 93.6%), 2-year rejection free survival (low IgG group 96.2% vs. high IgG group 89.3%). The incidence of graft failure and biopsy proven acute rejection, antibody mediated rejection showed no difference be-tween two groups (P=0.924, P=0.195, P=0.495). Posttransplant infectious disease (APN, pneumonia, etc.) occurs 10 (23.8%) in low IgG group, four (8.5%) in high IgG group.
Conclusions
There was no difference in postoperative outcome between high IgG group and low IgG group. This indicates that if successful desensitization is taken before transplantation, high baseline IgG titer does not increases risk of postoperative rejec-tion and graft failure.