@article{59eb9c64545e45a4b3c857e3e803d514,
title = "ABO Genotyping finds more A2 to B kidney transplant opportunities than lectin-based subtyping",
abstract = "ABO compatibility is important for kidney transplantation, with longer waitlist times for blood group B kidney transplant candidates. However, kidneys from non-A1 (eg, A2) subtype donors, which express less A antigen, can be safely transplanted into group B recipients. ABO subtyping is routinely performed using anti-A1 lectin, but DNA-based genotyping is also possible. Here, we compare lectin and genotyping testing. Lectin and genotype subtyping was performed on 554 group A deceased donor samples at 2 transplant laboratories. The findings were supported by 2 additional data sets of 210 group A living kidney donors and 124 samples with unclear lectin testing sent to a reference laboratory. In deceased donors, genotyping found 65% more A2 donors than lectin testing, most with weak lectin reactivity, a finding supported in living donors and samples sent for reference testing. DNA sequencing and flow cytometry showed that the discordances were because of several factors, including transfusion, small variability in A antigen levels, and rare ABO∗A2.06 and ABO∗A2.16 sequences. Although lectin testing is the current standard for transplantation subtyping, genotyping is accurate and could increase A2 kidney transplant opportunities for group B candidates, a difference that should reduce group B wait times and improve transplant equity.",
keywords = "ABO genotyping, ABO incompatibility, Dolichos biflorus lectin, donors and donation, kidney transplantation/nephrology, molecular biology, solid organ transplantation, translational research/science",
author = "Abigail Joseph and Murray, {Cody J.} and Novikov, {Natasha D.} and Velliquette, {Randall W.} and Sunitha Vege and Halls, {Justin B.L.} and Mah, {Helen H.} and Dellagatta, {Jamie L.} and Edward Comeau and Maria Aguad and Kaufman, {Richard M.} and Olsson, {Martin L.} and Indira Guleria and Stowell, {Sean R.} and Milford, {Edgar L.} and Hult, {Annika K.} and Yeung, {Melissa Y.} and Westhoff, {Connie M.} and Murphey, {Cathi L.} and Lane, {William J.}",
note = "Funding Information: This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Martin L. Olsson is a Wallenberg Clinical Scholar and this research was funded by grants from the Knut and Alice Wallenberg Foundation (grant no. 2020.0234), the Swedish Research Council (grant no. 2019-01683 to M.L.O.), and the Swedish government and county councils (grant no. ALFSKANE-446521 to M.L.O.). Annika Hult was supported by a Region Sk{\aa}ne Research and Development position. Funding Information: This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Martin L. Olsson is a Wallenberg Clinical Scholar and this research was funded by grants from the Knut and Alice Wallenberg Foundation (grant no. 2020.0234), the Swedish Research Council (grant no. 2019-01683 to M.L.O.), and the Swedish government and county councils (grant no. ALFSKANE-446521 to M.L.O.). Annika Hult was supported by a Region Sk{\aa}ne Research and Development position.The authors of this manuscript have conflicts of interest to disclose as described by the American Journal of Transplantation. WJL reports personal consulting fees from CareDx and One Lambda and his institution is a founding member of the Blood transfusion Genomics Consortium (BGC) that has received fees from Thermo Fisher Scientific to help co-develop a high-density DNA genotyping array. MYY reports personal consulting fees from One Lambda. All other authors have nothing to disclose. Publisher Copyright: {\textcopyright} 2022 American Society of Transplantation & American Society of Transplant Surgeons",
year = "2023",
month = apr,
doi = "10.1016/j.ajt.2022.12.017",
language = "English (US)",
volume = "23",
pages = "512--519",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "4",
}