Excellent outcomes of ABO-incompatible kidney transplantation: a single-center experience.
BACKGROUND
Due to the severe shortage of deceased donors in Japan, ABO-incompatible living donor kidney transplantation has been performed since the late 1980s. Excellent long-term outcomes have been achieved; the rates of graft survival among these patients are currently similar to those of recipients of ABO-compatible grafts. Our single-center experience describing the immunosuppressive protocols, complications, and grafts survivals is documented in this study.


METHODS
Among 123 patients with end-stage renal disease who underwent living donor kidney transplantation between January 1999 and December 2010, 25 cases were ABO-incompatible grafts. All of these patients were followed until August 2011. Analyzing these patients, we focused on their immunosuppressive protocols, complications, and graft survivals.


RESULTS
Patient and graft survival rates were 100%. One patient experienced antibody-mediated rejection and an intractable acute cellular rejection episode, 1 patient an antibody-mediated rejection, and 6 patients had acute cellular rejection episodes. However, there were no severe complications.


CONCLUSIONS
Although ABO-incompatible kidney transplantation is a high-risk procedure, a short-term graft survival rate of 100% may be expected due to recent significant improvements in desensitization and recipient management.
Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan. m9492120@msic.med.osaka-cu.ac.jp
J
J
Uchida
N
N
Kuwabara
Y
Y
Machida
T
T
Iwai
T
T
Naganuma
N
N
Kumada
T
T
Nakatani
D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D001787:Blood Group Incompatibility / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000821:virology; D003888:Desensitization, Immunologic / Q000379:methods; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007564:Japan; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents