History of ABO Incompatible Pancreas Transplantation

Duck Jong Han, Takashi Kenmochi

Research output: Chapter in Book/Report/Conference proceedingChapter


ABO-incompatible transplants are rare but have been successfully performed in liver [1–3], heart [4], kidney [5, 6], and pancreas [7] transplants. ABO-incompatible transplants are usually performed only in life-threatening emergencies or in the presence of special immunologic conditions. One such condition is a transplant from blood group A2 donors to blood group 0 recipients. Its feasibility is based on the low expression of A2 (vs Al) determinants. Favorable outcome of A2 organs transplanted into 0 recipients had already been reported in the early 1980s [8, 9]. The recipient’s IgM anti-A2 titer appeared to be a key factor: Transplants with titers <1:64 usually succeeded, whereas titers ≥1:64 tended to fail. To avoid hyperacute rejection, prospective ABO-incompatible recipients require additional treatment: elimination of ABO isoagglutinins by plasmapheresis or immunoadsorption with or without concurrent recipient splenectomy [10, 11]. Removal of antiblood group IgM isoagglutinins prevents the development of hyperacute rejection early posttransplant; the return of those isoagglutinins after several weeks posttransplant appears to have no effect on graft function.

Original languageEnglish
Title of host publicationPancreas Transplantation–the Asian Experience
Subtitle of host publicationA Registry Report
PublisherSpringer Nature
Number of pages5
ISBN (Electronic)9789811645976
ISBN (Print)9789811645969
Publication statusPublished - 01-01-2021

All Science Journal Classification (ASJC) codes

  • General Medicine


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