Comparative analysis of ABO-incompatible living donor kidney transplantation with ABO-compatible grafts: a single-center experience in Korea

Serious organ shortages have necessitated the use of ABO-incompatible (ABOi) kidneys transplantation, which has been increasingly preformed in Korea. However there are few detailed comparative data regarding patient and graft survival, graft function, and complications in Korean patients receiving ABO-compatible (ABOc) and ABOi kidney transplants (KT).

This retrospective study compared 35 consecutive ABOi living donor KTs with 138 ABOc living donor KTs using same immunosuppressive regimens. We examined preoperative demographic factors, immunologic risk factors, patient and graft survivals, postoperative renal function, acute rejection episodes, infections, medical and surgical complications, duration of hospital stay as well as cause for readmission, and their rates.

Patient survival, graft survival, and graft function over the 2 years after transplantation were similar between the 2 groups. There were no significant differences in terms of complications with exception of bleeding and BK virus infection. Acute antibody-mediated rejection episodes, bleeding complications, BK virus infections, and preoperative hospital stay were significantly greater in the ABOi group (P = .001, P = .002, P = .005, and P < .001 respectively).

We concluded that, despite some disadvantages, ABOi KT is a viable, safe option for patients whose only available donor is blood group incompatible.