title: Three-year outcomes following 1420 ABO-incompatible living-donor kidney transplants performed after ABO antibody reduction: results from 101 centers.
abstract: BACKGROUND
  Reports from experienced centers suggest that recipients of an ABO-incompatible living-donor kidney transplant after reduction of ABO antibodies experience no penalty in graft and patient survival versus ABO-compatible transplants, but confirmation that these results can be widely replicated is lacking.
  
  
  METHODS
  Living-donor kidney transplants from ABO-incompatible donors after ABO antibody reduction registered with the Collaborative Transplant Study during 2005 to 2012 were analyzed and compared with (i) a matched group of ABO-compatible transplant recipients and (ii) all ABO-compatible transplants from centers that performed at least five ABO-incompatible grafts during the study period.
  
  
  RESULTS
  One thousand four hundred twenty living-donor ABO-incompatible kidney transplants were analyzed. Three-year death-censored graft survival was virtually identical for ABO-incompatible transplants versus matched and center controls (P=0.92 and P=0.60, respectively). Patient survival rates were also similar (P=0.15 and P=0.11, respectively). Early patient survival was lower in ABO-incompatible grafts (P=0.006 vs. matched controls; P=0.001 vs. center controls) because of a higher rate of early infectious death (P=0.037 and P<0.001, respectively). Death-censored graft and patient survival were not significantly affected by induction therapy and anti-CD20 treatment. ABO antibody reduction by column adsorption was associated with similar death-censored graft survival to plasmapheresis.
  
  
  CONCLUSIONS
  In this analysis of prospectively collected data from a large series of ABO-incompatible living-donor kidney transplants performed at 101 centers, death-censored graft and patient survival rates were similar to those achieved in ABO-compatible control groups over the same period.
authors: 1 Department of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany. 2 Department of Transplantation Nephrology, University of Heidelberg, Heidelberg, Germany.
authors: Gerhard
authors: G
authors: Opelz
authors: Christian
authors: C
authors: Morath
authors: Caner
authors: C
authors: Süsal
authors: Thuong Hien
authors: TH
authors: Tran
authors: Martin
authors: M
authors: Zeier
authors: Bernd
authors: B
authors: Döhler
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001787:Blood Group Incompatibility / Q000276:immunology / Q000628:therapy*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000401:mortality / Q000517:prevention & control*; D006085:Graft Survival; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood*; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000009:adverse effects / Q000401:mortality; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System; D015415:Biomarkers; D007518:Isoantibodies