title: Early post-transplant complications following ABO-incompatible kidney transplantation.
abstract: BACKGROUND
  Living-kidney transplantation is increasing because of the scarcity of kidneys from deceased donors and the increasing numbers of patients on waiting lists for a kidney transplant. Living-kidney transplantation is now associated with increased long-term patient- and allograft-survival rates.
  
  
  OBJECTIVE
  The purpose of this retrospective study was to identify, in a cohort of 44 ABO-incompatible (ABOi) live-kidney transplant patients, the main complications that occurred within 6 months post-transplantation, and to compare these findings with those from 44 matched ABO-compatible (ABOc) live-kidney transplant patients who were also from our center.
  
  
  METHODS
  This single-center retrospective study assessed post-transplantation complications in 44 ABO-i versus 44 matched ABO-c patients. All patients were comparable at baseline except that ABO-i patients had greater immunological risks.
  
  
  RESULTS
  During the 6-month post-transplant period, more ABO-i patients presented with postoperative bleeds, thus requiring significantly more blood transfusions. Bleeds were associated with significantly lower values of fibrinogen, platelets, prothrombin time, and hemoglobin levels. Surgical complications, patient- and graft-survival rates, and kidney-function statuses were similar between both groups at 6 months post-transplantation.
  
  
  CONCLUSIONS
  We conclude that impairment of hemostatic factors at pre-transplant explained the increased risk of a post-transplant bleed in ABO-i patients.
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: Hamza
authors.initials: H
authors.lastname: Naciri Bennani
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: Zhyiar
authors.initials: Z
authors.lastname: Abdulrahman
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: Asma
authors.initials: A
authors.lastname: Allal
authors.affiliation: Department of Urology, Andrology, and Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: Federico
authors.initials: F
authors.lastname: Sallusto
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Delarche
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France ; Department of Urology, Andrology, and Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Game
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Esposito
authors.affiliation: Department of Urology, Andrology, and Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Doumerc
authors.affiliation: Etablissement Français du Sang de Midi-Pyrénées, CHU Purpan, Toulouse, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Debiol
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France ; INSERM U563, IFR-BMT, CHU Purpan, Toulouse, France ; Université Paul Sabatier, Toulouse, France.
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France ; INSERM U563, IFR-BMT, CHU Purpan, Toulouse, France ; Université Paul Sabatier, Toulouse, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
keywords: BK virus; Bleeding; Blood transfusion; Fibrinogen; Kidney transplantation; Surgical complications