Outcomes of ABO Compatible and Incompatible Kidney Transplantation

GettyImages_493249067Philadelphia—Researchers in Korea recently conducted a study to compare outcomes in spousal donor kidney transplantations with ABO incompatible kidney transplantations versus ABO compatible kidney transplantations. Ji Hyun, MD, and colleagues reported results of the study during a poster session at Kidney Week in a poster titled Comparison of Outcomes from Spousal Donor Graft Between ABO Compatible and Incompatible Kidney Transplantation.

In a time of organ shortage, spousal donor and ABO incompatible kidney transplantations are viewed as good alternatives for living related ABO compatible donor kidney transplantations. For this study, the researchers compared clinical characteristics and outcomes, including survival rates for grafts and patients, in a group of patients undergoing living donor kidney transplantation between January 2009 and December 2012 at Seoul St. Mary’s hospital (n=326).

There were 56 patients in the ABO incompatible group. Of those, 39.3% (n=22/56) had spousal donors, compared with 23% (n=62/270) of patients in the ABO compatible group; P=.013). The 3-year survival rate was higher in the ABO compatible group compared with the ABO incompatible group (86.5% vs 65.3% P=.043).

Following exclusion of high titer (defined as baseline anti-A or anti-B immunoglobulin G isoagglutinin titer >1:512) ABO incompatible kidney transplantation recipients (n=5), there were no differences between the two groups in 3-year biopsy-proven acute rejection (BPAR)-free survival rates. Both the 3-year graft survival rate and patient-survival rate were comparable between the two groups (85.2% vs 95%; P=.065 and 95.5% vs 100%, P=.093, respectively).

At the first 3 months of follow-up, serum creatinine level was lower in the ABO incompatible kidney transplantation group (1.25 vs 1.45 mg/dL, P=.028). However, after the first 3 months, the difference between the two groups had disappeared.

In the group of ABO compatible kidney transplantation recipients, there was no difference in 3-year BPAR-free, graft, and patient survival rates among living related donor and living unrelated donor recipients. Among the ABO incompatible patients, there was no difference in 3-year BPAR-free, graft, and patient survival rates between ABO incompatible living related donors and the group (there were no unrelated donors in this group). Spousal donor kidney transplantation itself and spousal type did not affect graft survival.

In conclusion, the researchers said, “Outcomes of spousal donor graft in ABO incompatible kidney transplantation is comparable to those of ABO compatible kidney transplantation with respect to grafts and patient survival rates.”

Source: Yu JH, Chung BH, Choi BS, et al. Comparison of outcomes from spousal donor graft between ABO compatible and incompatible kidney transplantation. Abstract of poster presented at Kidney Week 2014, Philadelphia Pennsylvania, November 13, 2014.