Abstract
peak titers pre-Tx were 1:8 (0-1:64) for anti-A and 1:4 (0-1:32) for anti-B. Titres against the donor blood type tended to be lower postthan pre-Tx (p 0.09) but higher against third party in blood group O recipients. Induction was performed with ATG in 61%, anti-CD25ab in 32%, 7% received no induction. 4 episodes of acute cellular rejection ( 2R) 7 of ab-mediated rejection (AMR) were documented. 5 pts received ab removing treatment in the post-Tx phase either pre-emptively or due to AMR. 1 pt developed severe graft vasculopathy 5 years post-Tx. All patients received calcineurin Inhibitors, 62% mycophenolate, 10% azathioprine, 2% everolimus, 24% steroids. Freedom from death or re-Tx was 100%/96%/ 69% at 1/5/10 years. None of the 4 graft losses was attributed to AMR. Conclusions: Successful ABOi HTx can be performed at older age and with higher pre-Tx ab titres than previously assumed. Successful ABOi-Tx is possible without ATG induction or intensified maintenance immunosuppression with excellent mid-term survival. Severe rejection and graft vasculopathy are rare. Low post-Tx titres indicate accommodation or tolerance towards the donor blood group, or elements of both.
Published Version
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