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I am A1B positive, which blood group can donate me a kidney?

Q: I am 29 years old with A1B positive blood group. I have been diagnosed with IgA nephropathy and due for kidney transplantation for the last 3 months. Which blood group donors will match me?

A:There are case reports that describe the transplantation of a kidney from an A1B donor to a recipient who was blood group A2B or vice-versa. The donor/recipient pair may be ABO mismatched but compatible. In the majority of cases, A1 antibodies fail to react at 37 degrees C and are of no clinical significance. However, hemolytic transfusion reactions due to A1 antibodies active at 37 degrees C have been reported but are extremely rare. If there is lack of preformed anti-A2/anti-B antibodies in the recipient at the time of transplant, the transplant is more likely to succeed or an attempt is made to reduce the titre of antibodies prior to transplant. This can be done using rituximab and at the same time performing four to five plasmaphereses to reduce the isoaglutinins to below 1 : 4. The use of intravenous immunoglobulin (IVIG) prior to surgery also helps. and plasmaphereses can be performed in the first 2 weeks after transplantation to keep the isoaglutinins titer below 1 : 8.


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