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ABO-incompatible kidney transplant recipients experienced impaired early graft function compared to ABO-compatible recipients, possibly due to prolonged tacrolimus exposure. Long-term kidney allograft function was similar between groups.

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Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Pharmacology

Background:

  • Limited research exists on immunosuppressive induction therapy in ABO-incompatible kidney transplantation.
  • Understanding the impact of preconditioning regimens on early and late graft outcomes is crucial.

Purpose of the Study:

  • To evaluate short- and long-term renal allograft function in ABO-incompatible versus ABO-compatible kidney transplantation.
  • To correlate renal allograft function with tacrolimus 12-hr trough levels during induction therapy.

Main Methods:

  • A preconditioning regimen of tacrolimus, mycophenolate mofetil, and prednisolone for 13 days was used.
  • Renal allograft function was assessed up to 28 days and 1 year post-transplantation.
  • Tacrolimus 12-hr trough levels were monitored and correlated with graft function.

Main Results:

  • ABO-incompatible recipients showed impaired renal allograft function within 28 days post-transplantation compared to ABO-compatible recipients.
  • Higher tacrolimus trough levels were observed in the ABO-incompatible group pre- and immediately post-transplantation.
  • This impairment may be linked to tacrolimus-associated renal toxicity from prolonged pre-transplant exposure.

Conclusions:

  • Shorter tacrolimus pretreatment or lower target trough levels might improve early postoperative renal allograft function in ABO-incompatible kidney transplantation.
  • Despite initial differences, long-term kidney allograft function was comparable between ABO-incompatible and ABO-compatible groups at 1 year.