Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan;117(1):109-118.
doi: 10.1111/vox.13160. Epub 2021 Jun 9.

Challenges in antibody titration for ABO-incompatible renal transplantation

Htar Kahlyar  1 , David Roxby  2 , Tony Badrick  1 , Thiru Vanniasinkam  3
Affiliations

Challenges in antibody titration for ABO-incompatible renal transplantation

Htar Kahlyar et al. Vox Sang. 2022 Jan.

Abstract

Background and objectives: Accurate and regular monitoring of anti-A and anti-B titres pre- and post-transplantation plays a crucial role in the clinical management of patients receiving ABO-incompatible renal transplants. There is no standardized protocol or an external quality assurance program (EQA) currently available for this testing in Australia. The aim of this study was to investigate the diversity of techniques, test platforms and reagents that were currently in use in various laboratories with the aim of developing an EQA.

Materials and methods: An online survey was sent to the participants enrolled with the Royal College of Pathologists of Australasia Quality Assurance Program (RCPAQAP) to assess their interest in participation in the pilot study. A total of 24 participants who expressed interest were sent the group O plasma, A1 , A2 and B cells to perform ABO titration using their own methods.

Results: Participants reported a wide range of titre results, from 8 to 1024 for the anti-A titre using A1 cells, from 2 to 128 for anti-A titre using A2 cells and from neat to 32 for anti-B titre using B cells.

Conclusion: There was a wide variation in titre results between and within different technologies. These findings demonstrate the need for an ABO titration EQA. Development of a standard technique and participation in an EQA program should, over time, reduce variation and enable transferrable results across testing centres, which will assist in consistent clinical interpretation and better outcomes for patients.

Keywords: ABO; external quality assurance; renal transplantation; titration.

PubMed Disclaimer

References

REFERENCES

    1. Jha PK, Bansal SB, Sethi SK, Jain M, Sharma R, Nandwani A, et al. ABO-incompatible renal transplantation in developing world-crossing the immunological (and mental) barrier. Indian J Nephrol. 2016;26:113-8.
    1. ANZDATA. ANZDATA 43rd Annual Report 2020. Incidence of RRT in ESKD. anzdata.org.au. Australia and New Zealand Dialysis & Transplant Registry. 29th September 2020. https://www.anzdata.org.au/report/anzdata-43rd-annual-report-2020-data-t.... Accessed 11 Jan 2021.
    1. Kidney Health Australia. Kidney fast facts factsheet. Kidney.org.au. 2020. https://kidney.org.au/resources/factsheets-and-photosheets/kidney-fast-f.... Accessed 20 Nov 2018.
    1. Transplant Australia. Frequently asked questions. transplant.org.au. 2021. https://transplant.org.au/faq/. Accessed 9 Jan 2021.
    1. Assing K, Sprogoe U, Nielsen C, Rasmussen M, Yazer M, Bistrup C. Increased but stable isoagglutinin titers in hemodialysis patients. J Nephrol. 2019;32:121-7.

Substances

LinkOut - more resources