title: ABO-incompatible renal transplantation in developing world - crossing the immunological (and mental) barrier.
abstract: ABO incompatibility has been considered as an important immunological barrier for renal transplantation. With the advent of effective preconditioning protocols, it is now possible to do renal transplants across ABO barrier. We hereby present a single center retrospective analysis of all consecutive ABOi renal transplants performed from November 2011 to August 2014. Preconditioning protocol consisted of rituximab, plasmapheresis and intravenous immunoglobulin (IVIG) and maintenance immunosuppression consisted of tacrolimus, mycophenolate sodium, and prednisolone. The outcome of these ABOi transplants was compared with all other consecutive ABO-compatible (ABOc) renal transplants performed during same time. Twenty ABOi renal transplants were performed during the study period. Anti-blood group antibody titer varied from 1:2 to 1:512. Patient and graft survival was comparable between ABOi and ABOc groups. Biopsy proven acute rejection rate was 15% in ABOi group, which was similar to ABOc group (16.29%). There were no antibody-mediated rejections in ABOi group. The infection rate was also comparable. We conclude that the short-term outcome of ABOi and ABOc transplants is comparable. ABOi transplants should be promoted in developing countries to expand the donor pool.
authors.affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: P K
authors.initials: PK
authors.lastname: Jha
authors.affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: S B
authors.initials: SB
authors.lastname: Bansal
authors.affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Sethi
authors.affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: M
authors.initials: M
authors.lastname: Jain
authors.affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: R
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: A
authors.initials: A
authors.lastname: Nandwani
authors.affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: M K
authors.initials: MK
authors.lastname: Phanish
authors.affiliation: Department of Lab Medicine, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: R
authors.initials: R
authors.lastname: Duggal
authors.affiliation: Department of Transfusion Medicine, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Tiwari
authors.affiliation: Department of Urology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: P
authors.initials: P
authors.lastname: Ghosh
authors.affiliation: Department of Urology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: R
authors.initials: R
authors.lastname: Ahlawat
authors.affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: V
authors.initials: V
authors.lastname: Kher
keywords: ABO incompatible; ABOi; India; developing world; renal transplantation