How an ABO-incompatible graft may contribute to its survival by phenotype-specific glycosylation of the host. A hypothesis.

In contrast to non-nucleated ABO-incompatible red cells, which from a HLA-compatible donor are transfused to a blood group O(H) recipient and undergo immediate destruction, a nucleated, metabolic active tissue that from the same donor is transplanted to the same recipient may,<i> </i>taking into account the effect of all therapeutic measures, occasionally show extreme long survival times. It appears to be established that tissue transplants always maintain their original, phenotype-specific metabolic properties, and expanding the concept of “glycosidic exclusion”, a transplanted ABO-incompatible, metabolically active tissue potentially uses its phenotype-specific enzymatic equipment to contribute to a compatible environment by consistent glycosylation of complementary sites of the plasma proteins and the differentiating B-cell surfaces of a HLA-compatible recipient. <br>