ABO incompatibility in cadaver donor kidney allografts

We have found the ABO barrier does appear to remain intact in clinical kidney transplantation, as evidenced by a 4% 1-year graft survival in 25 cadaver donor, ABO-incompatible allografts. The one long-term surviving graft could have been a case of an A2 kidney and a B recipient, but this could not be determined. Although these grafts were the result of errors at a number of different points, most could have been avoided if a red cell crossmatch had been performed at the time of transplant. The fact that these transplants rarely occur should not overshadow the possibility that they could be avoided by the implementation of such a simple procedure.