Transplantation of ABO group A2 kidneys from living donors into group O and B Recipients

Fifteen blood group O and B recipients have been transplanted with kidneys from subtype A(2) living donors since April 1992. ABO red cell grouping was performed by local licensed blood banks with A(2) subtype determined using an anti-A(1) lectin and, retrospectively, by a polymerase chain reaction (PCR)-based molecular method. All grafts functioned immediately and no patient has required (.)dialysis. Three patients each experienced one reversible rejection episode. With the exception of one cardiac death at 9 months and one patient with profound toxicity to calcineurin inhibitors, all allografts continue to function normally. One donor, mistyped as a group A(2) using lectin, was by PCR typing an A(1)O(1) nonsecretor; the graft continues to function normally at 30 months. Transplantation of living donor A(2) renal allografts into non-A recipients produces excellent long-term allograft survival and expands the potential living donor pool for nonblood group A recipients.