Comparison of clinical and pathological features of rejection in ABO-incompatible and ABO-compatible kidney transplantation
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Background: ABO-incompatible (ABOi) living donor kidney transplantation (LDKT) is gradually being implemented to overcome the shortage of donor kidneys.Since ABOi LDKT began in 2007 in Korea, there have not been yet sufficient reports regarding the posttransplant long term outcomes including the incidence of rejection of ABOi LDKT.We analyzed the decade of our experiences of ABOi LDKT with comparing ABO-compatible (ABOc) LDKT from the standpoint of rejection and de novo donor-specific alloantibody (DSA).Methods: We retrospectively analyzed 1,190 living donor kidney transplant recipients between July 2010 and December 2020 at the Severance Hospital.We compared clinical outcomes and rejection type of ABOi LDKT (n=246) with those of ABOc LDKT (n=749).Results: No significant difference in death-censored graft survival was observed between ABOi KT and ABOc KT (P=0.217).Patient survival after ABOi KT was similar to that after ABOc KT (95.0% vs. 97.3%,respectively; P=0.108).The prevalence of de novo DSA production and biopsy-proven acute T-cell mediated rejection (TCMR) and chronic antibody-mediated rejection (ABMR) were comparable between the two groups.The incidence of biopsy-proven active ABMR was significantly higher ABOi KT than ABOc KT (9.8% [24/246] vs. 5.5% [41/749], respectively; P=0.018).In addition, biopsy-proven acute rejection (BPAR) free survival rate was lower in ABOi KT than ABOc KT (71.8% vs. 76.4%,respectively; P=0.024).Multivariable cox regression confirmed that DR and DQ associated de novo DSA was independently associated BPAR but ABO incompatibility was not a significant risk factor of BPAR after adjustment with covariates.Conclusions: ABOi LDKT was not inferior to ABOc LDKT for patient survival and graft survival.However, ABO incompatibility was associated with the increased incidence of active ABMR.Keywords:
ABO incompatibility
ABO incompatibility
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ABO incompatibility
Corneal Transplant
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ABO incompatibility
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Economic shortage
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Objective:To investigate ABO blood type in kidney transplantation cases.Methods:The survey was on the 143 cases with kidney transplantation.Results:The difference of ABO blood type between the kidney transplantation cases and normal group is no significant.The blood type of the cases one by one in order are O(40.5%),A(32.9%),B(18.9),AB(7.7%).In the 143 cases,B(18.9%)is lower the normal group(22.9%),O(40.5%)is higher the normal group(34.8%),the difference is no significant.Conclusion:ABO blood type is no obvious effect on kidney transplantation cases.
Blood type (non-human)
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ABO incompatibility
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When a renal transplant candidate's only medically-acceptable living kidney donor is ABO incompatible, the most common practice is to place them on the deceased donor list. Over the past few years, the implementation of paired kidney donor exchange programs and the development of protocols to overcome the ABO blood group barrier have become much more successful and widespread. Here we review the therapeutic options for patients whose only living kidney donor is ABO incompatible, with a specific emphasis on the rationale for and the current outcomes of ABO incompatible living donor kidney transplantation.
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