Long-term Follow-up of ABO-Incompatible Kidney Transplantation in Freiburg, Germany: A Single-Center Outcome Report.

Publisher: Elsevier Science Inc Country of Publication: United States NLM ID: 0243532 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2623 (Electronic) Linking ISSN: 00411345 NLM ISO Abbreviation: Transplant Proc Subsets: MEDLINE

Publication: New York, N.Y. : Elsevier Science Inc.
Original Publication: New York Stratton.

Blood Group Incompatibility/*mortality ; Graft Rejection/*mortality ; Kidney Transplantation/*mortality ; Postoperative Complications/*mortality ; Renal Insufficiency, Chronic/*surgery; Adult ; Blood Group Incompatibility/immunology ; Blood Group Incompatibility/surgery ; Blood Grouping and Crossmatching ; Cohort Studies ; Female ; Follow-Up Studies ; Germany ; Glomerular Filtration Rate ; Graft Rejection/immunology ; Graft Survival/immunology ; Humans ; Immunosuppression Therapy/methods ; Immunosuppression Therapy/mortality ; Kidney Transplantation/methods ; Living Donors ; Lymphocele/immunology ; Lymphocele/mortality ; Male ; Middle Aged ; Postoperative Complications/immunology ; Renal Insufficiency, Chronic/immunology ; Survival Rate ; Treatment Outcome

Background: ABO-incompatible kidney transplantation (ABOi-KT) is an established way to enlarge the donor pool around the world. Comparability of long-term success and complications to ABO-compatible kidney transplantation (ABOc-KT) are still under debate.
Methods: We evaluated all patients with a living donor kidney transplantation performed between April 1, 2004, and March 31, 2019.
Results: A total of 137 ABOi-KT and 346 ABOc-KT were analyzed. We excluded 4 ABOi-KT recipients and 178 ABOc-KT recipients with cyclosporine A-based immunosuppression or without basiliximab induction. Three patients of the ABOi-KT cohort and 6 patients of the ABOc-KT cohort were lost to follow-up and therefore excluded. The patient characteristics were comparable except for the higher age of transplant recipients in the ABOc-KT cohort and longer follow-up of the ABOi-KT cohort. The mean estimated 15-year recipient survival was 89% in the ABOi-KT cohort and 91% in the ABOc-KT cohort (P = .39). Mean estimated graft survival was 71% in the ABOi-KT cohort and 87% in the ABOc-KT cohort (P = .68). The estimated glomerular filtration rate (Modification of Diet in Renal Disease) measured in the last follow-up was 51 mL/min/1.73 m ² in the ABOi-KT cohort and 50 mL/min/1.73 m ² in the ABOc-KT cohort (P = .36). The incidence for antibody-mediated rejection, T cell-mediated rejections, and infectious complications requiring hospitalization was not different between the cohorts. In the ABOi-KT cohort, we found significantly more lymphoceles and consequent surgical revision procedures.
Conclusions: At our center, ABOi-KT has as good long-term results as ABOc-KT in terms of patient survival, graft survival, and complications, with the exception of increased lymphocele formation.
(Copyright © 2020 Elsevier Inc. All rights reserved.)

Date Created: 20201012 Date Completed: 20210607 Latest Revision: 20211204

20240628

10.1016/j.transproceed.2020.09.001

33041078