Journal of Nephrology

, Volume 32, Issue 1, pp 121–127 | Cite as

Increased but stable isoagglutinin titers in hemodialysis patients

  • Kristian AssingEmail author
  • Ulrik Sprogoe
  • Christian Nielsen
  • Mads Rasmussen
  • Mark Yazer
  • Claus Bistrup
Original Article



Prior to an ABO incompatible kidney transplantation it is important to know the recipient’s pre-transplantation anti-A and/or anti-B (isoagglutinin) titer. This study determined if pre-transplantation isoagglutinin titers remained stable, over a period of 1 year, among hemodialysis patients.


Blood was collected four times, every 3 months from 54 hemodialysis patients (hemodialysed trice per week ≥ 6 months), and 56 healthy volunteers. Measurement of anti-A and anti-B (IgM and IgG) titers were performed on an automated solid phase analyzer. The titers were converted to log2 titer steps (e.g., titer 32 = titer step 5).


Within blood group O, mean IgG anti-A and anti-B titers were significantly higher in the hemodialysis patients (n = 22, mean titer step: anti-A: 6.4 and anti-B:4.9), compared to the healthy volunteers [n = 19, mean titer step: anti-A: 4.9 and anti-B:3.5, p = 0.02 (anti-A) and p = 0.03 (anti-B)], despite blood group O hemodialysis patients having significantly lower total plasma IgG levels (median 8.1 g/L) than healthy volunteers (11.1 g/L, p = 0.001). Neither age, nor gender determined IgG anti-A or anti-B titers. In hemodialysis patients and healthy volunteers, the upper 95% confidence limit of anti-A and anti-B titer variation (IgM and IgG) during 1 year, did not exceed 1.0 titer step in any of the ABO groups.


Anti-A and -B titers (IgM and IgG) remained stable in both the hemodialysis patients and healthy volunteers over a period of approximately 1 year. Blood group O hemodialysis patients had, despite lower total IgG levels, significantly elevated IgG anti-A and -B titers.


Hemodialysis Isoagglutinins Titers Dynamics Memory B cells 


Author contributions

KA designed the study, collected samples and drafted the paper; US designed the study, performed the statistics and revised the paper; CN and MR carried out experiments; MY designed the study and revised the paper; CB took care of the HD patients and revised the paper; all authors approved the final version of the manuscript.

Compliance with ethical standards

Conflict of interest

This manuscript has not been published previously and is being submitted only to Journal of Nephrology. It will not be submitted elsewhere while under consideration and, should it be published in Journal of Nephrology, it will not be published elsewhere—either in similar form or verbatim—without permission of the editors. All authors are responsible for reported research and have participated in the concept and design, analysis and interpretation of data, drafting or revising, and have approved this manuscript as submitted.

Human and animal rights statement

Approved by the Regional Committees on Health Research Ethics for Southern Denmark (protocol-id: S-20110085).

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Nephrology 2018

Authors and Affiliations

  • Kristian Assing
    • 1
    Email author
  • Ulrik Sprogoe
    • 1
  • Christian Nielsen
    • 1
  • Mads Rasmussen
    • 1
  • Mark Yazer
    • 1
    • 2
  • Claus Bistrup
    • 3
  1. 1.Department of Clinical ImmunologyOdense University HospitalOdense CDenmark
  2. 2.Department of Pathology, Institute for Transfusion MedicineUniversity of PittsburghPittsburghUSA
  3. 3.Department of NephrologyOdense University HospitalOdenseDenmark

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