title: Ongoing higher infection rate in ABO-incompatible kidney transplant recipient: is it a serious problem? A single-center experience.
abstract: OBJECTIVE
  Additional clinical experience and knowledge regarding the barrier to transplantation of ABO blood type incompatibility could reduce the higher rate of infectious complications in ABO-incompatible kidney transplantation.
  
  
  METHODS
  A total of 79 ABO-incompatible kidney transplantation (ABOiKT) patients were compared with 260 ABO-compatible kidney transplantation (ABOcKT) patients for basic clinical characteristics, infectious complications, rejection episodes, and graft survival.
  
  
  RESULTS
  There were no significant differences in baseline characteristics, rejection rates, or graft survival between the ABOiKT and ABOcKT patients. No significant difference in the infection rate was shown for cytomegalovirus (26.6% vs. 30.0%; P = 0.672), BK virus (19.0% vs. 21.5%; P = 0.752), herpes disease (10.1% vs. 5.0%; P = 0.082), pneumonia (5.3% vs. 3.8%; P = 0.746), or urinary tract infection (8.9% vs. 10.0%; P > 0.999). Female sex (hazard ratio [HR], 2.20; P = 0.003), advanced age (≥60 years) (HR, 2.5; P = 0.019), history of rejection episodes (HR, 2.28; P = 0.016), and history of surgical complications (HR, 4.64; P = 0.018) were significant risk factors for infection. ABO incompatibility demonstrated a tendency toward higher infection risk without statistical significance (HR, 1.74; P = 0.056).
  
  
  CONCLUSIONS
  In spite of immunosuppressant protocol modification, the rate of infectious complications following ABOiKT is still higher than with ABOcKT when a modified desensitization protocol is used. However, this was not sufficient to avoid ABOiKT.
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Byung Hyun
authors.initials: BH
authors.lastname: Choi
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
keywords: ABO incompatibility; Infection; Kidney transplantation