TY - JOUR
T1 - ABO-incompatible kidney transplantation in perspective of deceased donor transplantation and induction strategies
T2 - a propensity-matched analysis
AU - de Weerd, Annelies E
AU - van den Brand, Jan A J G
AU - Bouwsma, Hanneke
AU - de Vries, Aiko P J
AU - Dooper, Ine Ph M M
AU - Sanders, Jan-Stephan F
AU - Christiaans, Maarten H L
AU - van Reekum, Franka E
AU - van Zuilen, Arjan D
AU - Bemelman, Frederike J
AU - Nurmohamed, Azam S
AU - van Agteren, Madelon
AU - Betjes, Michiel G H
AU - de Jong, Margriet F C
AU - Baas, Marije C
N1 - Funding Information:
The authors have declared no funding.
Publisher Copyright:
© 2021 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.
PY - 2021/12
Y1 - 2021/12
N2 - Kidney transplant candidates are blood group incompatible with roughly one out of three potential living donors. We compared outcomes after ABO-incompatible (ABOi) kidney transplantation with matched ABO-compatible (ABOc) living and deceased donor transplantation and analyzed different induction regimens. We performed a retrospective study with propensity matching and compared patient and death-censored graft survival after ABOi versus ABOc living donor and deceased donor kidney transplantation in a nationwide registry from 2006 till 2019. 296 ABOi were compared with 1184 center and propensity-matched ABOc living donor and 1184 deceased donor recipients (matching: recipient age, sex, blood group, and PRA). Patient survival was better compared with deceased donor [hazard ratio (HR) for death of HR 0.69 (0.49–0.96)] and non-significantly different from ABOc living donor recipients [HR 1.28 (0.90–1.81)]. Rate of graft failure was higher compared with ABOc living donor transplantation [HR 2.63 (1.72–4.01)]. Rejection occurred in 47% of 140 rituximab versus 22% of 50 rituximab/basiliximab, and 4% of 92 alemtuzumab-treated recipients (P < 0.001). ABOi kidney transplantation is superior to deceased donor transplantation. Rejection rate and graft failure are higher compared with matched ABOc living donor transplantation, underscoring the need for further studies into risk stratification and induction therapy [NTR7587, www.trialregister.nl].
AB - Kidney transplant candidates are blood group incompatible with roughly one out of three potential living donors. We compared outcomes after ABO-incompatible (ABOi) kidney transplantation with matched ABO-compatible (ABOc) living and deceased donor transplantation and analyzed different induction regimens. We performed a retrospective study with propensity matching and compared patient and death-censored graft survival after ABOi versus ABOc living donor and deceased donor kidney transplantation in a nationwide registry from 2006 till 2019. 296 ABOi were compared with 1184 center and propensity-matched ABOc living donor and 1184 deceased donor recipients (matching: recipient age, sex, blood group, and PRA). Patient survival was better compared with deceased donor [hazard ratio (HR) for death of HR 0.69 (0.49–0.96)] and non-significantly different from ABOc living donor recipients [HR 1.28 (0.90–1.81)]. Rate of graft failure was higher compared with ABOc living donor transplantation [HR 2.63 (1.72–4.01)]. Rejection occurred in 47% of 140 rituximab versus 22% of 50 rituximab/basiliximab, and 4% of 92 alemtuzumab-treated recipients (P < 0.001). ABOi kidney transplantation is superior to deceased donor transplantation. Rejection rate and graft failure are higher compared with matched ABOc living donor transplantation, underscoring the need for further studies into risk stratification and induction therapy [NTR7587, www.trialregister.nl].
KW - ABO-incompatible kidney transplantation
KW - alemtuzumab
KW - deceased donor transplantation
KW - living donor transplantation
KW - patient and graft survival
KW - rejection
UR - http://www.scopus.com/inward/record.url?scp=85118866017&partnerID=8YFLogxK
U2 - 10.1111/tri.14145
DO - 10.1111/tri.14145
M3 - Article
C2 - 34687095
SN - 0934-0874
VL - 34
SP - 2706
EP - 2719
JO - Transplant International
JF - Transplant International
IS - 12
ER -