BACKGROUND: Reports from experienced centers suggest that recipients of an ABO-incompatible living-donor kidney transplant after reduction of ABO antibodies experience no penalty in graft and patient survival versus ABO-compatible transplants, but confirmation that these results can be widely replicated is lacking. METHODS: Living-donor kidney transplants from ABO-incompatible donors after ABO antibody reduction registered with the Collaborative Transplant Study during 2005 to 2012 were analyzed and compared with (i) a matched group of ABO-compatible transplant recipients and (ii) all ABO-compatible transplants from centers that performed at least five ABO-incompatible grafts during the study period. RESULTS: One thousand four hundred twenty living-donor ABO-incompatible kidney transplants were analyzed. Three-year death-censored graft survival was virtually identical for ABO-incompatible transplants versus matched and center controls (P=0.92 and P=0.60, respectively). Patient survival rates were also similar (P=0.15 and P=0.11, respectively). Early patient survival was lower in ABO-incompatible grafts (P=0.006 vs. matched controls; P=0.001 vs. center controls) because of a higher rate of early infectious death (P=0.037 and P<0.001, respectively). Death-censored graft and patient survival were not significantly affected by induction therapy and anti-CD20 treatment. ABO antibody reduction by column adsorption was associated with similar death-censored graft survival to plasmapheresis. CONCLUSION: In this analysis of prospectively collected data from a large series of ABO-incompatible living-donor kidney transplants performed at 101 centers, death-censored graft and patient survival rates were similar to those achieved in ABO-compatible control groups over the same period.
BACKGROUND: Reports from experienced centers suggest that recipients of an ABO-incompatible living-donor kidney transplant after reduction of ABO antibodies experience no penalty in graft and patient survival versus ABO-compatible transplants, but confirmation that these results can be widely replicated is lacking. METHODS: Living-donor kidney transplants from ABO-incompatible donors after ABO antibody reduction registered with the Collaborative Transplant Study during 2005 to 2012 were analyzed and compared with (i) a matched group of ABO-compatible transplant recipients and (ii) all ABO-compatible transplants from centers that performed at least five ABO-incompatible grafts during the study period. RESULTS: One thousand four hundred twenty living-donorABO-incompatible kidney transplants were analyzed. Three-year death-censored graft survival was virtually identical for ABO-incompatible transplants versus matched and center controls (P=0.92 and P=0.60, respectively). Patient survival rates were also similar (P=0.15 and P=0.11, respectively). Early patient survival was lower in ABO-incompatible grafts (P=0.006 vs. matched controls; P=0.001 vs. center controls) because of a higher rate of early infectious death (P=0.037 and P<0.001, respectively). Death-censored graft and patient survival were not significantly affected by induction therapy and anti-CD20 treatment. ABO antibody reduction by column adsorption was associated with similar death-censored graft survival to plasmapheresis. CONCLUSION: In this analysis of prospectively collected data from a large series of ABO-incompatible living-donor kidney transplants performed at 101 centers, death-censored graft and patient survival rates were similar to those achieved in ABO-compatible control groups over the same period.
Authors: Krista L Lentine; Bertram L Kasiske; Andrew S Levey; Patricia L Adams; Josefina Alberú; Mohamed A Bakr; Lorenzo Gallon; Catherine A Garvey; Sandeep Guleria; Philip Kam-Tao Li; Dorry L Segev; Sandra J Taler; Kazunari Tanabe; Linda Wright; Martin G Zeier; Michael Cheung; Amit X Garg Journal: Transplantation Date: 2017-08 Impact factor: 4.939
Authors: D Axelrod; D L Segev; H Xiao; M A Schnitzler; D C Brennan; V R Dharnidharka; B J Orandi; A S Naik; H Randall; J E Tuttle-Newhall; K L Lentine Journal: Am J Transplant Date: 2016-02-08 Impact factor: 8.086
Authors: Malte Ziemann; Wolfgang Altermann; Katharina Angert; Wolfgang Arns; Anette Bachmann; Tamam Bakchoul; Bernhard Banas; Annette von Borstel; Klemens Budde; Vanessa Ditt; Gunilla Einecke; Ute Eisenberger; Thorsten Feldkamp; Siegfried Görg; Martina Guthoff; Antje Habicht; Michael Hallensleben; Falko M Heinemann; Nicole Hessler; Christian Hugo; Matthias Kaufmann; Teresa Kauke; Martina Koch; Inke R König; Christine Kurschat; Claudia Lehmann; Matthias Marget; Anja Mühlfeld; Martin Nitschke; Luiza Pego da Silva; Carmen Quick; Axel Rahmel; Thomas Rath; Petra Reinke; Lutz Renders; Florian Sommer; Bernd Spriewald; Oliver Staeck; Dirk Stippel; Caner Süsal; Bernhard Thiele; Daniel Zecher; Nils Lachmann Journal: Clin J Am Soc Nephrol Date: 2019-06-18 Impact factor: 10.614
Authors: Rosalie A Poldervaart; Mirjam Laging; Tessa Royaards; Judith A Kal-van Gestel; Madelon van Agteren; Marry de Klerk; Willij Zuidema; Michiel G H Betjes; Joke I Roodnat Journal: J Transplant Date: 2015-09-02