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PubMed2004

[Multiple factors in erythrocytic recovery following ABO-incompatible allogeneic HSCT].

This study was aimed to investigate various factors influening erythrocyte recovery following ABO-incompatible allogeneic HSCT. 157 patients following ABO-incompatible allogeneic HSCT were selected for the investigation. Cox regression analysis were used to identify the statistically significant factors including sex, age, schemes of transplantation, HLA-matched, mismathed, conditioning regimens, preventive measures for GVHD, occurrence of grade I-II GVHD, CMV infections and types of incompatible blood group. The results showed that minor ABO-incompatible, number of mononuclear cells infused, age of patients and unrelated BMT were four important main factors influening the erythrocyte recovery. In conclusion, the erythrocyte recovery is more quick in patients with minor ABO-incompatible and more number of mononuclear cells infused, while it is slow in patents with old age and unrelated BMT.

ABO Blood-Group System↗
PubMed1994

Risk factors for liver transplantation across the ABO barrier.

A retrospective study was performed to identify risk factors affecting the fate of liver allografts transplanted across the ABO barrier. Over a 5-year period, 30 patients received 31 emergency OLTs with ABO-incompatible allografts. One-year graft and patient survival rates were 37.1% and 48.4%, respectively. This group was compared with 199 ABO-compatible OLTs performed under similar emergency conditions. Significantly higher incidence of rejection, hepatic artery thrombosis, and biliary stricture were found in ABO-incompatible grafts. The graft or patient survival of patients with O blood group or fulminant hepatic failure was not affected by ABO incompatibility. In contrast, the 1-year survival of recipients with non-O blood group was only 13.3% and the 1-year survival of those undergoing retransplantation was only 27.7% after ABO-incompatible OLT. A multivariate analysis using the Cox proportional hazard model identified non-O blood group (relative risk 3.43) and retransplantation (relative risk 2.46) as the most important risk factors for patient survival after ABO-incompatible OLT. We conclude that the use of ABO-incompatible grafts is justified in emergency cases when no other donor is available, but should be proscribed in patients with non-O blood group. The value of ABO-incompatible grafts in retransplantation is questionable and requires further investigation.

ABO Blood-Group System↗
PubMed1999

ABO incompatibility as an adverse risk factor for survival after allogeneic bone marrow transplantation.

BACKGROUND: Graft ABO incompatibility has not been thought to affect patient survival after allogeneic bone marrow transplantation, although it may be associated with prolonged erythroid aplasia and immediate or delayed hemolysis. STUDY DESIGN AND METHODS: A retrospective analysis of a cohort of 292 allogeneic transplant recipients measured survival in a subgroup of ABO-incompatible bone marrow graft recipients. RESULTS: Patients with acute myelogenous leukemia or myelodysplastic syndrome receiving non-T-cell-depleted bone marrow grafts had an 85-percent greater risk of death within 100 days of transplant (relative risk, 1.85, 95% CI, 1.33-2.58; p = 0.003) than comparable patients receiving ABO-compatible grafts. Both ABO major- and minor-mismatched graft recipients were at risk. The increased mortality rate was not due to an increase in graft failure or acute graft-versus-host disease; rather, patients died of multiple-organ failure and sepsis, which is consistent with regimen-related toxicity. This effect was not seen in a larger group of 112 chronic myelogenous leukemia patients undergoing similar treatment. CONCLUSION: ABO incompatibility may be a significant prognostic risk factor after allogeneic bone marrow transplantation in susceptible subgroups of recipients. Care is necessary to design hematopoietic stem and progenitor cell-processing and -transfusion policies to minimize this risk.

ABO Blood-Group System↗
PubMed2006

von Willebrand factor, endothelial dysfunction, and cardiovascular disease.

von Willebrand factor (VWF), a glycoprotein involved in arterial thrombus formation, is released into the circulation by secretion from endothelial cells. Plasma VWF levels are determined by genetic factors including ABO blood groups and VWF mutations, and by non-genetic factors including aging, impaired nitric oxide production, inflammation, free radical production and diabetes. Plasma VWF levels have been proposed as a risk factor for cardiovascular events. Although they are only weakly associated with the risk of coronary heart disease (CHD) in the general population, they are a more promising CHD risk factor in high-risk populations with previous cardiovascular events, diabetes or old age. However, is it still unclear whether VWF levels directly determine the rate and severity of arterial thrombus formation or whether they merely reflect alteration in other endothelial functions. The future status of VWF levels as a cardiovascular risk factor depends on additional studies on the genetic determinants of both VWF levels and cardiovascular outcomes. Further studies on VWF levels as a predictor of the risk of stroke (rather than CHD) in elderly or other high-risk population are also promising. Such studies could lead to the clinical use of plasma VWF levels to refine the estimation of the cardiovascular risk and of the expected benefit of antithrombotic agents.

Animals↗
PubMed2003

Measurement of von Willebrand factor activity: relative effects of ABO blood type and race.

Tests based on three different principles are reported to measure the activity of von Willebrand factor (VWF): ristocetin cofactor (VWF:RCo), collagen binding (VWF:CB), and the so-called "activity ELISA" (VWF:MoAb). We measured these and other diagnostic parameters in a population of 123 randomly selected female study controls, age 18-45 years. Type O subjects had significantly lower levels than non-O subjects in each test. Race differences were seen in all tests except VWF:RCo, with Caucasians having significantly lower levels than African-Americans. ABO differences accounted for 19% of the total variance in VWF:Ag (P < 0.0001) and race for 7% (P < 0.0001), for a total of 26%. Both effects were mediated through VWF:Ag and were independent. VWF:Ag level was the primary determinant of VWF function, accounting for approximately 60% of the variance in VWF:RCo and VWF:CB and 54% of the variance in factor VIII. The ratio VWF:RCo/VWF:Ag differed significantly by race within blood group. The median ratios were 0.97 for type O Caucasians vs. 0.79 for type O African-Americans and 0.94 for non-O Caucasians vs. 0.76 for non-O African-Americans. The ratio VWF:CB/VWF:Ag did not vary. This suggests racial differences in the interaction of VWF with GP1b but not with subendothelium. Alternatively, VWF:RCo may be regulated to maintain a relatively constant plasma level in the presence of excessive VWF:Ag. This heterogeneity within the normal population is partially responsible for the difficulty in defining diagnostic limits for von Willebrand disease.

ABO Blood-Group System↗
PubMed1988

Prevalence of ABO maternal-infant incompatibility in Asians, Blacks, Hispanics and Caucasians.

Previous studies suggest that race is a risk factor in ABO hemolytic disease of the newborn (ABO-HDN). In order to compare the prevalence of ABO-HDN in Asian, Black, Hispanic and Caucasian infants, we studied 10,611 consecutive births at one hospital over a 6-year period. Among group A infants born to group O mothers, the prevalence of positive DAT differed among the four groups (p = 0.007), and was highest in Asians (50%) and lowest in Caucasians (31%). However, the proportions of infants who required exchange transfusion were not different (p = 0.351). Among group B infants born to group O mothers, the prevalence of positive DAT was not different among the four groups (p = 0.26) and none of these 166 group B infants with a positive DAT result required exchange transfusion. Our findings suggest that there are small ethnic differences in the prevalence of positive DAT results in group A infants born to group O mothers, but the prevalence of clinical disease which requires exchange transfusion does not differ significantly among Asian, Black, Hispanic and Caucasian infants.

ABO Blood-Group System↗