Korean J Blood Transfus.  2022 Dec;33(3):145-153. 10.17945/kjbt.2022.33.3.1 4 5.

Comparison of Total and IgG ABO Isoagglutinin Titers in ABO-Incompatible Organ Transplant Patients: Analysis of Data from a University Hospital Over the Last 5 Years

• Kim JA
• Shin JW
• Lee DL
• Park S
• Kim J
• Bang HI

• KMID: 2537220
• DOI: http://doi.org/10.17945/kjbt.2022.33.3.1 4 5

Abstract

Background
Measurement of ABO isoagglutinin titers is important for patients who have received an ABO-incompatible organ transplant. Specifically, IgG isoagglutinin is essential for predicting graft outcomes in kidney transplantation, but many laboratories measure only the total isoagglutinin taking into consideration time and labor efficiency. In this study, we propose a useful method for predicting IgG isoagglutinin by analyzing the mathematical relationship between total and IgG isoagglutinin titers. Furthermore, the effects of patients’ characteristics of isoagglutinin were also analyzed.
Methods
From January 2017 to April 2022, the results of 3,676 total/IgG isoagglutinin titers of 65 patients who underwent liver and kidney transplantation were analyzed. Isoagglutinin titration was performed using the column agglutination technique with serially diluted serum samples and dithiothreitol was added for measuring IgG isoagglutinin. A generalized estimation equation (GEE) and the Deming regression were used to analyze the relationship and agreement of total/IgG isoagglutinin titers.
Results
In A, B, and O types, total isoagglutinin titers were 1.6 (2^67.1×10^–2 ), 1.9 (2^95.1×10^–2 ), and 2.0 (2^98.5×10^–2 ) times higher than IgG isoagglutinin, respectively, and the agreement between the two tests was high in all blood types. The blood types affected total/IgG isoagglutinin titers (P＜0.05, GEE), but age, sex, and the type of transplanted organs did not have a statistically significant effect.
Conclusion
We concluded that if measuring IgG isoagglutinin titers in ABO-incompatible organ transplant patients is not feasible, the relationship between total and IgG isoagglutinin, viz. total isoagglutinin titers=1.6, 1.9 or 2.0×IgG isoagglutinin for the A, B, and O type blood groups respectively can be used as an auxiliary means of prediction.

Keyword

Isoagglutinin titer; IgG isoagglutinin; Dithiothreitol; ABO-incompatible organ transplant