Excellent Outcomes of ABO-Incompatible Kidney Transplantation: A Single-Center Experience

• DOI: 10.1016/j.transproceed.2011.11.006
• Publication Date: 2012-02-10T22:20:05Z
• Authors: J. Uchida; N. Kuwabara; Y. Machida; T. Iwai; T. Naganuma; N. Kumada; T. Nakatani
• Keywords: Adult; Graft Rejection; Male; Time Factors; Graft Survival; Middle Aged; Kidney Transplantation; ABO Blood-Group System; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Japan; Desensitization, Immunologic; Blood Group Incompatibility; Histocompatibility; Cytomegalovirus Infections; Humans; Kidney Failure, Chronic; Female; Immunosuppressive Agents

Due to the severe shortage of deceased donors in Japan, ABO-incompatible living donor kidney transplantation has been performed since the late 1980s. Excellent long-term outcomes have been achieved; the rates of graft survival among these patients are currently similar to those of recipients of ABO-compatible grafts. Our single-center experience describing the immunosuppressive protocols, complications, and grafts survivals is documented in this study.Among 123 patients with end-stage renal disease who underwent living donor kidney transplantation between January 1999 and December 2010, 25 cases were ABO-incompatible grafts. All of these patients were followed until August 2011. Analyzing these patients, we focused on their immunosuppressive protocols, complications, and graft survivals.Patient and graft survival rates were 100%. One patient experienced antibody-mediated rejection and an intractable acute cellular rejection episode, 1 patient an antibody-mediated rejection, and 6 patients had acute cellular rejection episodes. However, there were no severe complications.Although ABO-incompatible kidney transplantation is a high-risk procedure, a short-term graft survival rate of 100% may be expected due to recent significant improvements in desensitization and recipient management.