title: Long-term survival of kidneys transplanted from live A2 donors to O and B recipients.
abstract: The long-term outcome of kidneys transplanted from blood group A(2) live donors into blood group O or B candidates is not known. From 1986 through 2006, we transplanted eight blood group O patients and one blood group B patient with kidneys from blood group A(2) live donors. Immunosuppression was no different for these patients than for ABO-compatible recipients. All patients received methylprednisolone, cyclosporine or tacrolimus and azathioprine or mycophenolate mofetil with or without antibody induction (monoclonal or polyclonal). Of the nine live-donor A(2) to O and B transplants performed, seven grafts remain functioning. One of those seven was lost to follow-up at 9.2 years with a functioning kidney. Of the remaining six patients, length of follow-up is 10.4, 6.5, 5.3, 4, 2.1 and 1 years. Of the two patients who lost their grafts, one died with a functioning graft (DWFG) at 8.8 years and one lost his graft at 13.2 years due to noncompliance with immunosuppression. These data show that good long-term graft survival can be expected in live-donor A(2) to O and B transplantation despite some of those patients experiencing the type of clinical problems seen with ABO-compatible transplants.
authors.affiliation: Midwest Transplant Network, Westwood, KS, USA. cbryan@mwtn.org
authors.forename: C F
authors.initials: CF
authors.lastname: Bryan
authors.forename: P W
authors.initials: PW
authors.lastname: Nelson
authors.forename: C F
authors.initials: CF
authors.lastname: Shield
authors.forename: B A
authors.initials: BA
authors.lastname: Warady
authors.forename: F T
authors.initials: FT
authors.lastname: Winklhofer
authors.forename: D
authors.initials: D
authors.lastname: Murillo
authors.forename: M R
authors.initials: MR
authors.lastname: Wakefield
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D001379:Azathioprine / Q000627:therapeutic use; D001788:Blood Grouping and Crossmatching; D016572:Cyclosporine / Q000627:therapeutic use; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology / Q000502:physiology*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology* / Q000379:methods / Q000502:physiology*; D019520:Living Donors; D008775:Methylprednisolone / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D001379:Azathioprine; D016559:Tacrolimus; D008775:Methylprednisolone