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Outcomes of ABO-incompatible kidney transplantation in older patients: a national cohort study

Authors
 Deok Gie Kim  ;  Juhan Lee  ;  Myoung Soo Kim  ;  Oh Jung Kwon  ;  Cheol Woong Jung  ;  Kang Wook Lee  ;  Jaeseok Yang  ;  Curie Ahn  ;  Kyu Ha Huh 
Citation
 TRANSPLANT INTERNATIONAL, Vol.34(2) : 290-301, 2021-02 
Journal Title
 TRANSPLANT INTERNATIONAL 
ISSN
 0934-0874 
Issue Date
2021-02
Keywords
ABO-incompatible ; kidney transplantation ; older
Abstract
Background: Outcomes of ABO-incompatible living donor kidney transplantation (ABOi LDKT) in older individuals have not been established. Methods: This multicentric observational study, using data from the Korean Organ Transplantation Registry database, included 634 older patients (≥60 years) undergoing kidney transplantation. We compared clinical outcomes of ABOi LDKT (n = 80) with those of ABO-compatible LDKT (ABOc LDKT, n = 222) and deceased donor kidney transplantation (DDKT, n = 332) in older patients. Results: Death-censored graft survival was similar between the three groups (P = 0.141). Patient survival after ABOi LDKT was similar to that after ABOc LDKT (P = 0.489) but higher than that after DDKT (P = 0.038). In multivariable analysis, ABOi LDKT was not risk factor (hazard ratio [HR] 1.73, 95% confidence interval [CI] 0.29-10.38, P = 0.548), while DDKT was significant risk factor (HR 3.49, 95% CI 1.01-12.23, P = 0.049) for patient survival. Although ABOi LDKT showed higher biopsy-proven acute rejection than ABOc LDKT, the difference was not significant after adjustment with covariates. However, ABOi LDKT was significant risk factor for infection (HR 1.66, 95% CI 1.12-2.45, P = 0.012). Conclusions: In older patients, ABOi LDKT was not inferior to ABOc LDKT and was superior to DDKT for patient survival. ABOi LDKT can be recommended for older patients, rather than waiting for DDKT.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/tri.13794
DOI
10.1111/tri.13794
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Lee, Ju Han(이주한)
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182156
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