AM25-MN-13-L - AABB/ASHI Symposium: Exploring Transplant Uncertainties/Conundrums in ABO

Proposed Session Description: The session is designed to review policy and practice related to ABO-incompatible transplantation. There will be a multidisciplinary approach including surgery, the histocompatibility laboratory and the transfusion service, which all need to work together to make ABO incompatible solid organ transplantation possible. The clinical need for increased ABO incompatible solid organ transplants, particularly renal transplant and pediatric heart transplants will be presented. ABO-histocompatibility testing and the current methods used to determine ABO immune risk assessment will be reviewed. The science surrounding the differential expression of ABO antigens on red blood cells versus endothelial cells and other solid organ tissues will be emphasized to demonstrate that testing of antigens on red blood cells may not adequately represent the ABO antigens in donor tissues. The variability in ABO antibody titers will be reviewed and the need for the automation of ABO antibody titers in resource constrained transfusion services to better support ABO incompatible solid organ transplants will be discussed. The session will end with an open forum for discussion.