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Successful launch of an ABO-incompatible kidney transplantation program to overcome the shortage of compatible living donors: Experience at a single center

Title
Successful launch of an ABO-incompatible kidney transplantation program to overcome the shortage of compatible living donors: Experience at a single center
Authors
Song S.H.Lee J.Kim B.S.Kim S.Lee J.G.Jeong H.J.Kim Y.S.Kim M.S.Kim H.O.Kim S.I.Huh K.H.
Ewha Authors
송승환
Issue Date
2017
Journal Title
Clinical Nephrology
ISSN
0301-0430JCR Link
Citation
vol. 88, no. 3, pp. 117 - 123
Keywords
ABO incompatibilityDesensitizationGraft survivalKidney transplantation
Publisher
Dustri-Verlag Dr. Karl Feistle
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Aims: ABO-incompatible (ABOi) kidney transplantation (KT) is being increasingly performed to overcome donor shortages. However, debate persists regarding the post-transplant outcomes of ABOi KT vs. that of ABO-compatible (ABOc) KT. Methods: A total 454 recipients who underwent living-donor KT (LDKT) between June 2010 and July 2014 at Severance Hospital (Seoul) were retrospectively reviewed. 100 ABOi and 354 ABOc KTs were compared. Recipients with a pretransplant positive crossmatch to their donors, pretransplant donor-specific anti-HLA antibody (DSA), or high panel reactive antibody (PRA ≥ 50%) were excluded from both the ABOi and ABOc KT groups. Finally, the authors compared the transplant outcomes of 95 of these ABOi KTs and 121 ABOc KTs performed over the same period. Results: No significant difference in incidence of biopsy-proven acute rejection was observed between the ABOi and ABOc KT groups (p = 0.230), and group glomerular filtration rate of ABOi KT was comparable to that of ABOc KT (p > 0.05 at all time points). 3-year deathcensored graft survival rates were similar (96.8 vs. 96.6%, respectively; p = 0.801). However, the incidences of postoperative bleeding, cytomegalovirus infection, fungal infection, and serious infection rates were significantly higher after ABOi KT. Conclusions: In this study, graft renal function and survival after ABOi KT were excellent, and the incidence of acute rejection was similar to that of ABOc KT. However, efforts are needed to reduce hemorrhagic and infectious complications after ABOi KT. ABOi KT can be a good strategy to overcome ABO antibody barriers and relieve donor shortage. © 2017 Dustri-Verlag Dr. K. Feistle.
DOI
10.5414/CN109114
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의료원 > 의료원 > Journal papers
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