Impact of ABO-Incompatible Living Donor Kidney Transplantation on Patient Survival

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Allan B MassieD L Segev

Abstract

Compared with recipients of blood group ABO-compatible (ABOc) living donor kidney transplants (LDKTs), recipients of ABO-incompatible (ABOi) LDKTs have higher risk for graft loss, particularly in the first few weeks after transplantation. However, the decision to proceed with ABOi LDKT should be based on a comparison of the alternative: waiting for future ABOc LDKTs (eg, through kidney paired exchange) or for a deceased donor kidney transplant (DDKT). We sought to evaluate the patient survival difference between ABOi LDKTs and waiting for an ABOc LDKT or an ABOc DDKT. Retrospective cohort study of adults in the Scientific Registry of Transplant Recipients. 808 ABOi LDKT recipients and 2,423 matched controls from among 245,158 adult first-time kidney-only waitlist registrants who did not receive an ABOi LDKT and who remained on the waitlist or received either an ABOc LDKT or an ABOc DDKT, 2002 to 2017. Receipt of ABOi LDKT. Death. We compared mortality among ABOi LDKT recipients versus a weighted matched comparison population using Cox proportional hazards regression and Cox models that accommodated for changing hazard ratios over time. Compared with matched controls, ABOi LDKT was associated with greater mortality risk in the f...Continue Reading

References

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Citations

Dec 2, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·Deok Gie KimUNKNOWN Korean Organ Transplantation Registry Study Group
Aug 17, 2021·Frontiers in Immunology·Vineeta Kumar, Jayme E Locke
Jun 9, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Andrew BentallSimon Ball
Oct 24, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·Annelies E de WeerdMarije C Baas

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