title: Maximising living donation with paediatric blood-group-incompatible renal transplantation.
abstract: Long-term outcomes for paediatric renal transplant recipients have improved over the last 20 years, with better patient and renal allograft survival. As paediatric renal transplantation programmes have increased over this timeframe, living donation has become the favoured modality for renal replacement therapy and is advocated pre-emptively in as many cases as possible. However, one of the main barriers historically to living donation has been ABO blood-group incompatibility, with the result that patients were listed to be on call for a deceased donor renal transplant. The clinical scenario has now changed so that donors and recipients for renal transplantation can be worked up and listed for paired exchange and/or living-related ABO blood-group-incompatible renal transplantation (ABOi). There is extensive data in adult practice, and increasing evidence in paediatric practice that the short- and medium-term outcomes for both patient and renal allograft survival for ABOi is equivalent to that of blood-group-compatible renal transplantation.
authors.affiliation: Department of Transplantation, Renal Unit, Guy's Hospital, London, SE1 9RT, UK.
authors.forename: Nizam
authors.initials: N
authors.lastname: Mamode
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Marks
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D001787:Blood Group Incompatibility / Q000276:immunology*; D001788:Blood Grouping and Crossmatching; D002648:Child; D046148:Donor Selection; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D006648:Histocompatibility; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000276:immunology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D019520:Living Donors / Q000600:supply & distribution*; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D000017:ABO Blood-Group System