316.7: ABO – Incompatible Kidney Transplantation in COVID 19 Era: A Single Centre Experience

Abstract

Introduction: Though there are multiple studies on outcome of ABO incompatible kidney transplants, we herein present the short term outcome of ABO-incompatible kidney transplantations done in the Covid-19 era. Methods: We analysed 40 consecutive ABO incompatible kidney transplant recipients undergone transplant from October 2020 till February 2022, followed up till March 2022.Included patients received rituximab 100 mg/200 mg depending on baseline anti ABO titre, plasma exchange and IVIG for desensitization. Target pre transplant anti ABO titre was ≤ 1:64.Patients received induction therapy with anti thymocyte globulin and IV methylprednisolone. Results: The median duration of follow up was 294 days. The highest baseline and pre transplant titre were 2048 and 64 respectively. The mean serum creatinine at discharge was 1.35±0.39 mg/dl and at follow up was 1.48 ± 0.59 mg/dl.The patient and death censored graft survival were 97.5% each. The single graft and patient loss was due to fungal pyelonephritis. 5 patients (12.5%) experienced episodes of biopsy proven rejection.3 patients (7.5%) had acute antibody mediated rejection and 2 patients (5%) suffered T Cell Mediated rejection. The post-transplant hospital stay was 12.79 ± 4.61 days. 5 patients needed hospitalisation for infection in the post transplant follow up period. 10 covid-19 recovered patients were transplanted after a mean duration of 88.4 days with mild to moderate severity. 3 patients (7.5%) acquired covid-19 post-transplantation, 2 in early post transplant (<3 months) and 1 patient at 5 months post-transplant period. Conclusion: There were no significant differences in the patient and graft survival in covid-19 era as compared to our pre covid studies. Rather, they had lower infection rates due to covid-19 related precautions. There was no increase in mortality or infection in a shorter term of follow up of our study period. Keywords: Short term outcome, ABO incompatible kidney transplantation, Covid19 Era.