Abstract
BackgroundABO incompatible kidney transplantation (ABOi-KT) is an important approach for overcoming donor shortages. We evaluated the effect of ABOi-KT on living donor KT.MethodsTwo nationwide transplantation databases were used. We evaluated the impact of ABOi-KT on overall living donor transplant activity and spousal donation as subgroup analysis. In addition, we compared the clinical outcome between ABOi-KT and ABO compatible KT (ABOc-KT) from spousal donor, and performed a Cox proportional hazards regression analysis to define the risk factors affecting the allograft outcomes.ResultThe introduction of ABOi-KT increased overall living donor KT by 12.2% and its portion was increased from 0.3% to 21.7% during study period. The ABOi-KT in living unrelated KT was two times higher than that of living related donor KT (17.8 vs.9.8%). Spousal donor was a major portion of living unrelated KT (77.6%) and ABOi-KT increased spousal donation from 10% to 31.5% in living donor KT. In addition, increasing rate ABOi-KT from spousal donor was 10 times higher than that of living related donor. The clinical outcome (incidence of acute rejection, allograft function, and allograft and patient survival rates) of ABOi-KT from spousal donor was comparable to that of ABOc-KT. Neither ABO incompatibility nor spousal donor was associated with acute rejection or allograft failure on multivariate analysis.ConclusionsABOi-KT increased overall living donor KT, and ABOi-KT from spousal donor is rapidly increasing with favorable clinical outcomes.
Highlights
During the past three decades, the structure of the Korean family has changed from large families to nuclear families
ABO incompatible (ABOi)-kidney transplantation (KT) increased overall living donor KT, and ABO incompatible KT (ABOi-KT) from spousal donor is rapidly increasing with favorable clinical outcomes
The number of ABOi-KT in living unrelated donor KT was less than living related donor KT (164 vs. 207) but proportion of ABOi-KT was two times higher than living related donor KT
Summary
During the past three decades, the structure of the Korean family has changed from large families to nuclear families. ABO blood type incompatibility was an important barrier of kidney transplantation (KT). We previously reported that the most common reason for the enrollment of donor kidney exchange program was ABO blood type incompatibility and the most common intended donor-recipient relationship was spousal.[4] it is expected that the introduction of ABO incompatible KT (ABOi-KT) will enable those patients to undergo KT, which will contribute to overcome donor kidney shortage. We interested in clinical outcomes of ABOi-KT from spousal donors as compared with the ABO compatible KT (ABOc-KT) from spousal donors. To evaluate these parameters, we used nationwide transplantation database. ABO incompatible kidney transplantation (ABOi-KT) is an important approach for overcoming donor shortages. We evaluated the effect of ABOi-KT on living donor KT
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