ABO-incompatible living-donor pediatric kidney transplantation in Japan

The Japanese ABO-Incompatible Transplantation Committee officially collected and analyzed data on pediatric ABO-incompatible living-donor kidney transplantation in July 2012. The age of a child was defined as <16 years, and 89 children who had undergone ABO-incompatible living-donor kidney transplantation from 1989 to 2011 were entered in a registry. These data were presented as the Japanese registry of pediatric ABO-incompatible living-donor kidney transplantation at the regional meetings of the International Pediatric Transplantation Association (IPTA) in Nagoya in September 2012 and in Sao Paulo in November 2012.

Use of the gel test to follow up chimerism in ABO mismatched bone marrow transplantation patient: a case report.

OBJECTIVE: The authors report here our experience using the gel test to follow up chimerism in a 5 year old girl with beta thalassemia/Hemoglobin E disease (beta thal/HbE), post allogeneic bone marrow transplantation with Hb E trait HLA identical sibling donor. They were ABO blood group major mismatched donor-recipient pairs (donor and recipient blood group are B and O, respectively). MATERIAL AND METHOD: Pre and post transplanted EDTA blood samples from the girl with beta thalassemia/ Hemoglobin E were tested for ABO, Rh and direct antiglobulin test (DAT) using the A-B-AB-D-ctl/ AHG card and the titer of anti-A and anti-B were tested by the conventional tube technique. The sex chromosome study and hemoglobin typing were also examined. RESULTS: In this technique, mixed field agglutination is clearly identified from positive and negative results. The authors detected peripheral recovery, mixed O/B population after transplantation on day +26 with positive DAT. The DAT was negative on day +67 after transplantation and the recipient blood group was completely changed to B on day +123. In addition, Hb typing was changed to Hb E trait with Hb F less than 5 % on day +37. The engraftment of neutrophils, more than 5x10(9)/L, was detected on day+14 and platelet count was more than 20x10(9)/L on day +28. On day +90, the patient was transfusion-independent with the mean Hb level at 11.4 g/dL (10.4-13.1). The sex chromosome and hemoglobin typing were changed to the donor on day +300. CONCLUSION: The gel test is an alternative method which is simple and helpful in detecting mixed red blood cell populations, particularly in the ABO or other blood group mismatched bone marrow transplantation.

Detection of high risk pregnancies with relation to ABO haemolytic disease of newborn.

IgM and IgG anti A and anti B antibody status of 100 antenatal O group mothers (who had non O group husbands) were studied. Of these, 3 mothers had an IgM anti A antibody levels ranging from 1:512 to 1:2048 and IgG ranging from 1:1204 to 1:2048, IgM anti B ranging from 1:128 to 1:512 and IgG anti B ranging from 1:256 to 1:512. All these mothers had A + ve children and all these children suffered from ABO haemolytic disease of newborn (HDN). A 4th mother had an IgM anti A titre of 1:64 and IgG anti A titre of 1:16. The titre of IgM anti B in this mother was 1:512 and that of IgG 1:1024. The child was A + ve and did not suffer from ABO haemolytic disease of newborn.

Unexpected red cell antibodies in donors and patients at Siriraj Hospital.

The incidence of unexpected red cell antibodies in patients and donors at Siriraj Hospital were found to be 4.91% and 4.33% respectively. Anti Lewis, anti P1 and anti Mia were the most common antibodies detected. Antibodies of Rh system were the next, in which anti E was more common than anti D. Anti Jka, Jkb, Fyb, Dia, S and rare antibodies such as anti K, Ge1, Mta and H were also detected in this study.