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Successful launch of an ABO-incompatible kidney transplantation program to overcome the shortage of compatible living donors: experience at a single center

 Seung Hwan Song  ;  Juhan Lee  ;  Beom Seok Kim  ;  Sinyoung Kim  ;  Jae Geun Lee  ;  Hyeon Joo Jeong  ;  Yu Seun Kim  ;  Myoung Soo Kim  ;  Hyun Ok Kim  ;  Soon Il Kim  ;  Kyu Ha Huh 
 Clinical Nephrology, Vol.88(9) : 117-123, 2017 
Journal Title
 Clinical Nephrology 
Issue Date
ABO Blood-Group System/immunology* ; Adult ; Blood Group Incompatibility/immunology* ; Female ; Graft Rejection/epidemiology ; Graft Survival ; Humans ; Incidence ; Kidney Transplantation* ; Living Donors* ; Middle Aged ; Retrospective Studies
AIMS: ABO-incompatible (ABOi) kidney transplantation (KT) is being increasingly performed to overcome donor shortages. However, debate persists regarding the post-transplant outcomes of ABOi KT vs. that of ABO-compatible (ABOc) KT. METHODS: A total 454 recipients who underwent living-donor KT (LDKT) between June 2010 and July 2014 at Severance Hospital (Seoul) were retrospectively reviewed. 100 ABOi and 354 ABOc KTs were compared. Recipients with a pretransplant positive crossmatch to their donors, pretransplant donor-specific anti-HLA antibody (DSA), or high panel reactive antibody (PRA ≥ 50%) were excluded from both the ABOi and ABOc KT groups. Finally, the authors compared the transplant outcomes of 95 of these ABOi KTs and 121 ABOc KTs performed over the same period. RESULTS: No significant difference in incidence of biopsy-proven acute rejection was observed between the ABOi and ABOc KT groups (p = 0.230), and group glomerular filtration rate of ABOi KT was comparable to that of ABOc KT (p > 0.05 at all time points). 3-year death-censored graft survival rates were similar (96.8 vs. 96.6%, respectively; p = 0.801). However, the incidences of postoperative bleeding, cytomegalovirus infection, fungal infection, and serious infection rates were significantly higher after ABOi KT. CONCLUSIONS: In this study, graft renal function and survival after ABOi KT were excellent, and the incidence of acute rejection was similar to that of ABOc KT. However, efforts are needed to reduce hemorrhagic and infectious complications after ABOi KT. ABOi KT can be a good strategy to overcome ABO antibody barriers and relieve donor shortage.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
김명수(Kim, Myoung Soo) ORCID logo https://orcid.org/0000-0002-8975-8381
김범석(Kim, Beom Seok) ORCID logo https://orcid.org/0000-0002-5732-2583
김순일(Kim, Soon Il) ORCID logo https://orcid.org/0000-0002-0783-7538
김신영(Kim, Sin Young) ORCID logo https://orcid.org/0000-0002-2609-8945
김유선(Kim, Yu Seun) ORCID logo https://orcid.org/0000-0002-5105-1567
김현옥(Kim, Hyun Ok) ORCID logo https://orcid.org/0000-0002-4964-1963
이재근(Lee, Jae Geun) ORCID logo https://orcid.org/0000-0002-6722-0257
이주한(Lee, Ju Han)
정현주(Jeong, Hyeon Joo) ORCID logo https://orcid.org/0000-0002-9695-1227
허규하(Huh, Kyu Ha) ORCID logo https://orcid.org/0000-0003-1364-6989
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