Kidd antibodies and renal transplant

[mrosebug]

We have a 15 yo male patient who is 9 years post renal transplant. Last known transfusion was in 1996. This patient has been identified with anti-JkB in solid phase with 2 and 3+ reactions. Patient presents with slightly decreased urine output but clinically is otherwise asymptomatic. He been noncompliant with medication.

The technical manual gives a brief mention of Kidd antibodies acting as histocompatiblity antigens in renal transplant. I have not found any other illuminating information on this relationship. I found it curious that the reactions were so strong (and neatly fitting) in a patient so far removed from transfusion. I know that Kidds famously do not always follow the rules but...

I was hoping someone might have further information or insight.

Thanks in advance!

Mary

Edited August 13, 2010 by mrosebug
additional detail

[LaraT23]

This is just my own supposition, but since Jkb is expressed in on kidney tissue cells, is the the transplanted kidney Jkb pos? Also, the genetic tie for the entire kidd system is that is it located on the urea transporter gene, and so goes with the kidney tissue expression. I would check on the kidd antigen status of both recipent and donor, it might shed a little light on things. The decreased urine output also makes sense for the recipient to be kidd neg, as those individuals are clinically unable to maximally concentrate urine. Of course the patient would also have to be Jka neg to have that affect.

[mrosebug]

Thanks for the input. Patient typed Jka+b-. I don't know about the donor but it would be interesting.

Mary