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ABO antibodies (isoagglutinins) represent a formidable barrier to optimizing live donation and organ distribution. Blood group antigens are expressed on the endothelium of solid organs, and transplantation across a blood group barrier can result in hyperacute or acute antibody-mediated rejection (AMR). Based on blood group distributions in the United States, there is a 36% probability that any two individuals in the population will be ABO incompatible (ABOi), resulting in the exclusion of up to one third of willing live donors.
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Robert A. Montgomery (2004) studied this question.
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