Anti-At^a in a renal transplant candidate: a case report

A patient with end-stage renal disease on chronic dialysis was admitted to the hospital for renal transplantation evaluation. Blood type and antibody detection tests were performed. The antibody detection test results were positive. Initial antibody identification studies indicated the presence of a panagglutinin. The patient’s autocontrol was negative. The antibody was subsequently identified by a reference laboratory as anti-At^a (Augustine), which is an extremely rare antibody due to the high prevalence of At^a in the general population. A monocyte monolayer assay (MMA) was performed to assess the clinical significance of the antibody in the event that blood was needed for transfusion, and At(a–) RBCs were not available. The MMA results predicted the antibody to be capable of causing hemolysis in vivo. A brief historical review of the incidence and clinical significance of this antibody is included in this case report.