037 Successful ABO and HLA incompatible renal transplantation in children in the united kingdom over the last decade

Abstract

Introduction There is increasing evidence of good short and medium term outcomes for ABO incompatible (ABOi) and HLA incompatible (HLAi) with pre-transplant positive crossmatches in paediatric practice. However, there are concerns regarding the higher risks of infective complications and antibody-mediated rejections. The aim of this paper is to show that the short-term outcomes for ABOi and HLAi renal transplantation are comparable to (ABOc/HLAc) compatible renal transplants in children in the UK. Methods Data were obtained from the UK Transplant Registry (NHS Blood and Transplant) on all children (aged Results Pre-emptive transplantation occurred in 35% and 25% of ABOi and HLAi recipients with delayed graft function in 3%, 6% and 0% of ABOc/HLAc, ABOi and HLAi respectively with no cases of primary non-function. Renal allograft survival was 100% in each group although there was one death of ABOi pRTR with a functioning graft. For ABOi transplants (n=16), the median and inter-quartile range (IQR) eGFR was 88 (63 – 150) mls/min/1.73 m2. The eGFR in ABOc/HLAc group had a median (IQR) of 101 (74 – 144) mls/min/1.73 m2. No statistically significant difference was found between these transplant groups due to the small number of patients. Conclusion The short term outcomes from this follow-up have shown that ABOi and HLAi renal transplantation are possible for paediatric renal transplant recipients in situations where no compatible donors are available.