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Background and Objectives: The Writing Committee of American Society for Apheresis released the ninth edition of guidelines for therapeutic apheresis in 2023. Categories have been a part of the guidelines since the first edition, and the grading system was introduced in the fifth edition, with updates in every new edition. In this study, we investigated the category and grade change trends through the latest five editions, focusing on therapeutic plasma exchange, to suggest future directions as part of evidence‐based medicine. Materials and Methods: Categories and grades for therapeutic plasma exchange (TPE) were collected and analysed from the fifth through ninth editions. We aligned classification changes to the ninth edition's clinical context and compared its categories and grades with those introduced in the guideline. Results: Among 166 total indications in the ninth edition, 118 included TPE procedure, either as a sole treatment or as one of the therapeutic apheresis techniques. The total number of indications changed, but Category III remained predominant throughout the editions. Similarly, Grade 2C consistently emerged as the most prevalent grade. Notably, 24 cases had grade changes. Of the 16 cases with evidence quality changes, the quality weakened in six and improved in 10. Evidence levels were not improved throughout the study period for 102 clinical conditions. Conclusion: To address gaps in evidence quality, international collaboration is imperative to establish comprehensive large‐scale studies or randomized controlled trials. This will refine the use of therapeutic apheresis, including TPE, to foster evidence‐based advancements in clinical practice. [ABSTRACT FROM AUTHOR]

Precision‐placed atom qubits in silicon offer a unique means to confine electrons and control their spins with extreme accuracy, which can be leveraged to construct powerful quantum computers. To date atom qubits in silicon have been successfully realized using electrons hosted either on a single phosphorus atom or on a multi‐donor quantum dot. Here, a novel molecular regime is explored in which electrons are bound to two donor dots separated by ≈8 nm in a natural silicon substrate. The molecular state, provided by these spatially separated donors, is used to study with exquisite precision the impact of confinement potential on the electronic and spin properties of qubits. Unique spin filling measurements, performed on up to five electrons, confirm how electrons are shared between both sites of the molecule, forming hybridized molecular states. The precise atomic locations of the donor atoms in the silicon lattice are determined by combining the experimental electron spin resonance spectra and the state‐of‐the‐art atomistic modeling of multi‐electron wave‐functions in presence of realistic electric fields. The donor molecule studied in this work exhibits excellent qubit properties and addresses the impact that the confinement potential has, at the atomic scale, on the desired properties of electron spin qubits. [ABSTRACT FROM AUTHOR]

Controlling electron tunneling is of fundamental importance in the design and operation of semiconductor nanostructures such as field effect transistors (FETs) and quantum computing device architectures. The exponential sensitivity of tunneling with distance requires precise fabrication techniques to engineer the desired device dimensions to achieve the appropriate tunneling resistances/tunnel rates. This is particularly important for high fidelity spin readout and qubit exchange in quantum computing architectures. Here, it is shown by combining precision fabrication techniques with accurate atomistic modeling, predictive device design criteria are achieved at atomic length scales. Such a tool is useful when devices become more complex or have arbitrary shapes/geometries. In particular, in this study, atomic precision patterning of monolayer degenerately phosphorus‐doped silicon tunnel junctions patterned by scanning tunnelling microscopy lithography and tight‐binding non‐equilibrium Green's function (TB‐NEGF) modeling is combined to describe the dependence of tunnel junction resistance RT on junction length. An agreement with experiment to within a factor of 2 over 4 orders of magnitude in RT is found, and this model allows to accurately determine the barrier height V0 = 57.5 ± 1 meV and lateral seam sxy = 0.39 ± 0.01 nm in these nanoscale junctions. This study confirms the use of the TB‐NEGF formalism to accurately model highly doped atomically precise tunnel junctions in silicon. Further applications of this model will enable improved device performance at the nanoscale. [ABSTRACT FROM AUTHOR]

Objective We compared the clinical outcomes of recipients of ABO-incompatible (ABOi) kidney transplantation (KT) according to the blood group of the plasma transfused. Materials and Methods We retrospectively analyzed the data of 60 recipients of ABOi-KT with blood type O and A or B donors. Demographic and clinical characteristics were compared between 2 groups of recipients: 1 group received AB plasma regardless of the donor's blood type (n = 30), and the other group received donor-type plasma (n = 30). Results There were no significant differences between the groups in terms of demographic characteristics. Transfusion of donor-type plasma was noninferior to transfusion of type AB plasma in terms of both rejection-free survival and rejection rate (P =.455, P =.335). Conclusion There was no significant prognostic difference between the 2 groups. In terms of blood supply and inventory management, we suggest that the blood group of the plasma should match the donor's type. [ABSTRACT FROM AUTHOR]

Background and objectives: The ABO antibody (Ab) titration tests are used in monitoring in ABO-incompatible (ABOi) solid organ transplantation (SOT). However, currently developed ABO Ab tests show Ab binding reactions. This study attempted to measure ABO Ab level using complement-dependent cytotoxicity (CDC). Materials and methods: We studied 93 blood group O serum samples from patients who underwent ABOi SOT from January 2019 to May 2021. Patients' sera were incubated with A1 or B cells and added to a human complement solution. Supernatants were collected after centrifugation, and free hemoglobin (Hb) was measured by spectrophotometry. We converted plasma Hb value to hemolysis (%), which were compared with ABO Ab titer. Results: We found a mild correlation between hemolysis and ABO Ab titers. In simple regression analysis, the correlation coefficients were within 0.3660–0.4968 (p < 0.0001) before transplantation. In multiple linear regression analysis, anti-A hemolysis (%) was higher in immunoglobulin M (IgM) (β = 12.9) than in immunoglobulin G (IgG) (β = −3.4) (R2 = 0.5216). Anti-B hemolysis was higher in IgM (β = 8.7) than in IgG (β = 0.0) (R2 = 0.5114). There was a large variation in hemolysis within the same Ab titer. Conclusions: CDC can be used in a new trial for ABO Ab measurement. Furthermore, IgM rather than IgG seems to play a significant role in vivo activity, consistent with previous knowledge. Thus, this study may help in the development of the ABO Ab titration supplement test for post-transplant treatment policy establishment and pre-transplant desensitization. [ABSTRACT FROM AUTHOR]

Objective We designed a study to compare the efficacy of cryoprecipitate-reduced plasma (CRP) and fresh frozen plasma (FFP), at the level of individual sessions, for treating refractory thrombotic microangiopathy (TMA) with therapeutic plasma exchange (TPE). Materials and Methods Platelet counts (× 10³/μL) and lactate dehydrogenase (LD; IU/L) levels were measured before and after each session. We compared the mean-percentage and absolute changes in platelet count and LD after each TPE session. Results The data from 33 patients treated for TMA between 2009 and 2018 were collected for this study. Both absolute and percentage increases in the platelet count were statistically significant (P =.003 and P =.011, respectively) when CRP was used. However, when patients were divided into subgroups according to specific diagnosis, no significant differences were found among the groups, except in terms of the absolute platelet count increase in the thrombotic thrombocytopenic purpura group (P <.001). Conclusion The platelet count increase was higher when patients received CRP than when they received FFP. We found that CRP may be a rescue option for patients with refractory TMA. [ABSTRACT FROM AUTHOR]

Background and Objectives: Temperature indicators (TIs) are used to monitor the surface temperature of red blood cell (RBC) units. We compared the utility of a newly developed time–temperature indicator (TTI) prototype, Freshzone TTI (FZTTI) (Freshzone, Seoul, South Korea) and two US Food and Drug Administration–approved TIs, Safe‐T‐Vue 10 (STV10; Temptime Corporation, Morris Plains, NJ) and Blood Temp 10 (BT10; Timestrip UK Ltd, Cambridge, UK). Materials and Methods: FZTTI, STV10 and BT10 were attached to 91 RBC units after issue (including eight units that were stored in refrigerators in the ward before transfusion). The time for colour change (CC) was monitored based on the 30‐min rule. The CC of FZTTI indicated the total time elapsed since the temperature of RBC units exceeded 10°C, and the CC of STV10 and BT10 indicated that the temperature of RBC units exceeded 10°C. Results: In 83 units, the median time for CC differed significantly between FZTTI and the TIs (51.4 min in FZTTI vs. 13.9 min in STV10 and 10.5 min in BT10, both at p < 0.001). In addition, 95.2% (n = 79) of FZTTI tags changed colour after 30 min of issue, whereas 96.4% (n = 80) of STV10 and 98.8% (n = 82) of BT10 changed colour within 30 min of issue. In the eight units stored in refrigerators, the time for CC between the TTI and TIs was significantly different. Conclusion: FZTTI outperformed the TIs, indicating that it is a feasible option for use in transfusion practice. [ABSTRACT FROM AUTHOR]

Background: Criteria for selection of FFP blood type has not been clearly established and use of group AB plasma is preferred by numerous transplantation protocols. Aims: This study assesses the safety and efficacy of alternative group A or B plasma in ABO incompatible solid organ transplantation. Materials & Methods: Alternative use of group A or B plasma (incompatible plasma) was inevitable during the shortage of group AB plasma. Experience from select number of patients during the period of extreme group AB plasma shortage is described. Results: The result of alternative use of group A or B plasma was within expectation, showing effective reduction of isoagglutinin titers for pre‐operative desensitization and efficacy for treatment of post‐operative patients. No immediate hemolytic transfusion reaction was reported. Discussion: While validation in a larger cohort of patients is necessary, our limited experience have shown satisfactory clinical outcomes without adverse events. Conclusions: Use of incompatible group A or B plasma is a viable option when group AB plasma is limited. [ABSTRACT FROM AUTHOR]

This article analyzes the development of nuclear power politics in Taiwan since 2016. In particular, it attempts to identify changing and/or recurring patterns of interaction between parties/politicians and civil society. Although more fluid forms of interest representation have emerged in recent decades, partisan strategies are still useful tools for social movements, especially as environmental/energy issues are highly politicized. Thus, existing institutional channels such as referendums and elections easily become battlefields for pro‐ and anti‐nuclear camps. How do the relevant actors in nuclear power politics interact regarding the current Democratic Progressive Party government's plan for a nuclear power phase‐out? While adopting a mechanism‐based approach, this article focuses specifically on explicating the interactions between parties/politicians and civil society. This article particularly highlights the role of civil society organizations and their activists, who straddle the line between political parties and civil society. These actors demonstrate both potential and limitations when it comes to changing the dynamics that exist between relevant actors in an iron triangle. [ABSTRACT FROM AUTHOR]

Introduction: Autologous peripheral blood stem cell (PBSC) transplantation has become a standard treatment option for many oncology patients. The aim of this study was to evaluate the performance of two cell separators, Spectra Optia (Terumo BCT, Japan) and Amicus (Fresenius‐Kabi) for autologous PBSC collection. Methods: We retrospectively evaluated 56 apheresis by Spectra Optia with Continuous Mononuclear Cell Collection (cMNC) from 20 patients, and 50 apheresis by Amicus from 27 patients between December 2018 and December 2019. CD34+ collection efficiency (CE2) and platelet (PLT) loss were evaluated. Results: There was no significant difference in CD34+ CE2 between Spectra Optia with cMNC (median, 28.8%) and Amicus (median, 33.1%; P = 0.537). PLT loss was significantly lower in Amicus (median, 28.6%) than in Spectra Optia with cMNC (median, 37.8%; P = 0.009). Conclusion: CD34+ CE2 was comparable between Spectra Optia and Amicus, and PLT loss was significantly lower in Amicus. To the best of our knowledge, this is the first report comparing autologous PBSC collection of the Spectra Optia and Amicus. These results may provide general guidance with regard to device selection to apheresis clinics that use both separators for optimal outcomes depending on each patient's characteristics. [ABSTRACT FROM AUTHOR]

Myelodysplastic syndrome (MDS) that evolves into acute leukemia with blasts of mixed phenotypes has rarely been reported and has no distinct diagnostic category. Herein, we describe a 79-year-old Korean female patient with MDS–excess blasts (MDS-EB) that evolved into acute leukemia; the blasts simultaneously expressed B-lymphoid and myeloid antigens. The patient was diagnosed with MDS-EB with blasts of myeloid lineage coexpressing a few B-lymphoid antigens with 7q and 20q abnormalities. The disease progressed to acute leukemia with blasts carrying more B-lymphoid antigens, which was immunophenotypically compatible with B-lymphoid/myeloid acute leukemia. Unlike previously reported patients whose blast populations are bilineal, our patient is the first with biphenotypic acute leukemia that progressed from MDS. The diagnosis of our patient introduces the possibility that many other types of biphenotypic acute leukemia may have gone undiagnosed and encourages hematologists to designate a specific diagnostic category for this type of disease, so that it can more readily be detected and studied in the future. [ABSTRACT FROM AUTHOR]

Objectives: We reanalyzed the data from proficiency testing (PT) to assess the effect of the geometric mean in the statistical analysis of immunohematologic data.Methods: Using the five most recent anti-blood group antibody titer participant summary results, the geometric mean (GM) ±2 × geometric standard deviation (GSD) was used as the comparative consensus criterion to mode ±2 titers.Results: Using the PT evaluation criterion of mode ±2 titers, the mean percentages of participants with acceptable results were 97.5% and 97.8% for anti-A and anti-D, respectively. When applying GM ±2 GSD, the mean percentages of acceptable results were 96.1% (anti-A) and 96.1% (anti-D). The percentages of responses included in each consensus criterion were lower using GM ±2 GSD, with a few exceptions.Conclusions: Geometric means are more robust and precise in visualizing the central tendency. This method can improve the statistical robustness of PT evaluations. [ABSTRACT FROM AUTHOR]

Yousun Chung traces the development of nuclear power politics in Taiwan since 2016, examining whether the partisan struggles that characterized nuclear power politics in Taiwan have been replaced by other types of interaction between political parties and civil society. Taedong Lee investigates the reasons why Korean governments drastically altered their heavy reliance on an export-driven nuclear energy policy to pursue a post-nuclear energy transition from 2008 to 2017. Beyond vested interests with a domestic focus (i.e., maintaining or expanding nuclear power in the energy mix), actors promoting nuclear energy may seek additional benefits, such as the exportation of nuclear plants and related technology. [Extracted from the article]

Since the retreat of the workplace system, Chinese cities have been presented with the important challenge of refurbishing local administrative systems at the sub-district level while meeting the emerging needs of new urban spaces. Building on new institutionalism concepts such as conversion and layering, this study examines conditions in Shanghai to ascertain what has made it a strong administrative city. The study discusses the development of Shanghai's current local governance structure in terms of historical legacy, formal structure, and informal practices (i.e., two-tiered government and three-tiered management). This study also researches the complex state task of strengthening sub-district governance (so-called "community construction") in urban China. The results of this study offer theoretical implications for institutional change and continuity related to these matters, thereby indicating that increased attention should be given to the agency-side explanation of endogenous institutional changes in the Chinese polity. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to establish the Korean national registry, to evaluate the distribution of unexpected antibodies, and to determine the frequencies of specific antigen-negative blood units.Methods: Data added to the Korean national registry between July 2013 and April 2016 were analyzed. The distribution of unexpected antibodies and frequencies of specific antigen-negative blood units were estimated.Results: In total, 3,513 cases from 22 institutes were registered. The most common single alloantibodies were anti-E, anti-Lea, and anti-M. The most common multiple alloantibodies were anti-E with anti-c, anti-C with anti-e, and anti-Lea with anti-Leb. The frequencies of E-, Lea-, and M-negative units were 42.3%, 56.9%, and 20.2%, respectively.Conclusions: The distribution of unexpected antibodies and frequencies of specific antigen-negative blood units were investigated using data from the Korean national registry. The results provide useful data to predict the number of blood units to be tested to obtain compatible blood units. [ABSTRACT FROM AUTHOR]

Urine erythrocyte (Ery) and leukocyte (Leu) dipstick tests are essential for detecting microhematuria and urinary tract infection. Currently, there is no suggestion for establishing the cut-off limits in an ordinal scale test. This study aimed to establish the cut-off limits for urine Ery and Leu dipstick tests via probit regression. From 1 January 2016 to 30 June 2016, laboratory data were collected from patients at one teaching hospital whose specimen had analytical results from both a urine dipstick test and an automated urine particle analyzer. Probit regression was used to estimate the probability of positive urine dipstick results as a function of log-transformed urine Ery and Leu concentrations. Based on the analysis of 22,122 specimens, the estimated concentration that yields 50% positive results (C50) of the Ery weak+, 1+, 2+, 3+, and 4 + dipstick results were 14.6, 40.4, 51.6, 136.3 and 219.0 × 106/L, respectively. The estimated C50 of the Leu 1+, 2+ and 3 + dipstick results were 22.7, 67.9 and 283.9 × 106/L, respectively. The estimated values were different from arbitrary concentrations provided for each dipstick category by the manufacturer. If a quantitative comparison method/procedure is available, the cut-off limits of an ordinal scale test can be established using probit regression. Each laboratory should investigate the transferability of the arbitrary concentrations provided by the manufacturer, and if necessary, determine its own cut-off limits of urine Ery and Leu dipstick tests. [ABSTRACT FROM AUTHOR]

This article compares the different trajectories of nuclear power policy in Japan, Taiwan and Korea in the post-Fukushima era. The Fukushima nuclear accident ratcheted up the level of contention between civil activism and supporters of nuclear power in all three states. The result of this contention has been decided by the combined effects of two factors – interest structure (complexity vs simplicity) and politicisation (national level vs local level). In terms of scope, policy change has taken place in Taiwan, Japan and Korea in that order. This analysis contributes to a balanced understanding of both structural constraints and the political process in which each actor, and in particular civil activism, is able to manoeuvre. [ABSTRACT FROM PUBLISHER]

Staphylococci are the leading cause of nosocomial blood stream infections. Fast and accurate identification of staphylococci and confirmation of their methicillin resistance are crucial for immediate treatment with effective antibiotics. A multiplex real-time PCR assay that targets mecA, femA specific for S. aureus, femA specific for S. epidermidis, 16S rRNA for universal bacteria, and 16S rRNA specific for staphylococci was developed and evaluated with 290 clinical blood culture samples containing Gram-positive cocci in clusters (GPCC). For the 262 blood cultures identified to the species level with the MicroScan WalkAway system (Siemens Healthcare Diagnostics, USA), the direct real-time PCR assay of positive blood cultures showed very good agreement for the categorization of staphylococci into methicillin-resistant S. aureus (MRSA), methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. epidermidis (MRSE), methicillin-susceptible S. epidermidis (MSSE), methicillin-resistant non-S. epidermidis CoNS (MRCoNS), and methicillin-susceptible non-S. epidermidis CoNS (MSCoNS) (κ=0.9313). The direct multiplex real-time PCR assay of positive blood cultures containing GPCC can provide essential information at the critical point of infection with a turnaround time of no more than 4 h. Further studies should evaluate the clinical outcome of using this rapid real-time PCR assay in glycopeptide antibiotic therapy in clinical settings. [ABSTRACT FROM AUTHOR]

This article discusses the evolution of urban homeowner activism in two senses: internally (growth through internal diversity) and externally (advancement in interaction with the state). The combination of these two aspects has directed the activism toward the expansion of its boundaries, as well as advanced representation and participation. Based on cumulative fieldwork carried out since 2007, I discuss two homeowner organizations in Beijing as core cases. Rights activism by homeowners has grown beyond the state-set boundaries of individual neighborhoods and has begun deploying innovative strategies and adapting existing institutions for its own use. Rights awareness and manifestation by social actors has evolved continuously. This evolution suggests the emergence of a complex interplay between state and society which goes beyond a confrontational or lopsided relationship. [ABSTRACT FROM PUBLISHER]

Multiplex nucleic acid amplification assays that simultaneously detect multiple respiratory pathogens in a single nasopharyngeal swab (NPS) specimen are widely used for rapid clinical diagnostics. We evaluated Allplex Respiratory Panel (RP) 1, 2, 3, and the BioFire FilmArray RP assay for detecting respiratory pathogens from NPS specimens. In all, 181 NPS specimens obtained from patients suspected of having respiratory infections during the non-influenza season (August–December 2019) were included. The Allplex RP 1, 2, and 3 detected 154 samples positive for respiratory viruses, whereas the BioFire FilmArray detected viruses in 98 samples. Co-infection with two or more viruses was detected in 41 and 17 NPS specimens by Allplex RP and the BioFire FilmArray RP, respectively. For adenoviruses, Allplex RP 1 detected 31 specimens, compared to 34 by the BioFire FilmArray. In all, 64 NPS specimens were positive for human enterovirus (HEV) and human rhinovirus (HRV) on the Allplex RP, in contrast to 39 HEV/HRV on the BioFire FilmArray. The parainfluenza virus (PIV-1–4) detection rate differed between the two systems. Most discrepant results were observed for NPS specimens with high cycle threshold values obtained by Allplex RP. This study showed concordant performance of the Allplex RP 1, 2, 3, and the BioFire FilmArray RP for the simultaneous detection of multiple respiratory viruses. [ABSTRACT FROM AUTHOR]

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI–TOF MS) has been widely used for microbial identification, because of its speed and accuracy, since its introduction to clinical microbiology laboratories. In this study, we evaluated the performance of ASTA MicroIDSys, a newly developed MALDI–TOF, and compared it with the widely used Bruker Biotyper. Microbial identification with the Bruker Biotyper system was performed by using a direct smear method and the Bruker Biotyper database (reference library version 6.0.0.0). The isolates were also tested in parallel, using the ASTA MicroIDSys system with a direct smear method and the MicroIDSys database, CoreDB v1.26. A total of 914 clinical isolates were recovered from the clinical specimens. Identical results with confidence scores (≥2.0, for the Bruker Biotyper) and acceptable scores (≥140 for the ASTA MicroIDSys) were obtained for 840 (91.9%) isolates. The minor errors were defined as misidentification at the species level, and the rate was 1.1% (9/792) for Bruker Biotyper and 1.6% (13/792) for ASTA MicroIDSys. Major errors were defined as misidentification at the genus level, and the rate was 0.3% (2/792) for both Bruker Biotyper and ASTA MicroIDSys. ASTA MicroIDSys showed reliable performance for microbial identification, which was comparable to that of the Bruker Biotyper. Therefore, ASTA MicroIDSys can be applied for the identification of microorganisms in clinical microbiology laboratories. [ABSTRACT FROM AUTHOR]

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious pathogen in clinical settings and early detection is critical. Here, we investigated the MRSA discrimination potential of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) using 320 clinical S. aureus isolates obtained in 2005–2014 and 181 isolates obtained in 2018. We conducted polymerase chain reactions (PCR) for staphylococcal cassette chromosome mec (SCCmec) typing and MALDI-TOF MS to find specific markers for methicillin resistance. We identified 21 peaks with significant differences between MRSA and methicillin-susceptible S. aureus (MSSA), as determined by mecA and SCCmec types. Each specific peak was sufficient to discriminate MRSA. We developed two methods for simple discrimination according to these peaks. First, a decision tree for MRSA based on six MRSA-specific peaks, three MSSA-specific peaks, and two SCCmec type IV peaks showed a sensitivity of 96.5%. Second, simple discrimination based on four MRSA-specific peaks and one MSSA peak had a maximum sensitivity of 88.3%. The decision tree applied to 181 S. aureus isolates from 2018 had a sensitivity of 87.6%. In conclusion, we used specific peaks to develop sensitive MRSA identification methods. This rapid and easy MALDI-TOF MS approach can improve patient management. [ABSTRACT FROM AUTHOR]

Cytoplasmic FMR1-interacting protein 2 (CYFIP2) is an evolutionarily conserved protein with a critical role in brain development and function. As a key component of the WAVE regulatory complex, CYFIP2 regulates actin cytoskeleton dynamics, essential for maintaining proper neuronal morphology and circuit formation. Recent studies have also shown that CYFIP2 interacts with various RNA-binding proteins, suggesting its involvement in mRNA processing and translation in neurons. Since 2018, de novo CYFIP2 variants have been identified in patients with neurodevelopmental disorders, particularly developmental and epileptic encephalopathy and West syndrome, characterized by early-onset intractable seizures, intellectual disability, microcephaly, and developmental delay. This review summarizes these CYFIP2 variants and examines their potential impact on the molecular functions of CYFIP2, focusing on its roles in regulating actin dynamics and mRNA processing/translation. Additionally, we review various Cyfip2 mouse models, highlighting the insights they offer into CYFIP2 function, dysfunction, and clinical relevance. Finally, we discuss future research directions aimed at better understanding CYFIP2-associated neurodevelopmental disorders and potential therapeutic strategies., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: This study aimed to evaluate whether a 2-week period of daily isoagglutinin titer testing after ABO-incompatible kidney transplantation (ABOi-KT) is sufficient to ensure successful engraftment and to advocate for an extension of the monitoring duration in specific situations., Methods: We reviewed patients from January 2022 to December 2023 at Asan Medical Center who underwent therapeutic plasma exchange (TPE) due to elevated ABO antibody titers and suspected acute antibody-mediated rejection (AMR) after ABOi-KT. Data collected included pre- and posttransplantation laboratory results, clinical and procedural information, imaging studies, and needle biopsy results of the renal graft., Results: We encountered 3 cases of acute AMR 2 weeks after transplantation. All cases exhibited simultaneous increases in anti-ABO antibody isoagglutinin titers, creatinine, and C-reactive protein levels. Clinical signs, including fever, suggested possible infection, and renal graft biopsy, confirmed AMR in all cases. Two cases underwent graftectomy, while the third recovered renal function after conservative treatment, including TPE., Conclusions: Our findings suggest that a 2-week monitoring period for isoagglutinin titers after ABOi-KT may not be sufficient to detect late AMR. Extending the monitoring duration and considering lifelong fresh-frozen plasma transfusion with graft-compatible blood types, along with periodic isoagglutinin titer testing in cases of suspected AMR, may improve long-term graft outcomes., (© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)