TY - JOUR
T1 - ABO Blood Incompatibility Positively Affects Early Graft Function
T2 - Single-Center Retrospective Cohort Study
AU - Watari, Shogo
AU - Araki, Motoo
AU - Wada, Koichiro
AU - Yoshinaga, Kasumi
AU - Maruyama, Yuki
AU - Mitsui, Yosuke
AU - Sadahira, Takuya
AU - Kubota, Risa
AU - Nishimura, Shingo
AU - Kobayashi, Yasuyuki
AU - Takeuchi, Hidemi
AU - Tanabe, Katsuyuki
AU - Kitagawa, Masashi
AU - Morinaga, Hiroshi
AU - Kitamura, Shinji
AU - Sugiyama, Hitoshi
AU - Wada, Jun
AU - Watanabe, Masami
AU - Watanabe, Toyohiko
AU - Nasu, Yasutomo
N1 - Publisher Copyright:
© 2021
PY - 2021/6
Y1 - 2021/6
N2 - Background: We investigated the association between ABO-incompatible (ABO-I) kidney transplantation and early graft function. Methods: We retrospectively analyzed 95 patients who underwent living donor kidney transplantation between May 2009 and July 2019. It included 61 ABO-compatible (ABO-C) and 34 ABO-I transplantations. We extracted data on immunologic profile, sex, age, cold ischemic time, type of immunosuppression, and graft function. Two definitions were used for slow graft function (SGF) as follows: postoperative day (POD) 3 serum creatinine level >3 mg/dL and estimated glomerular filtration rate (eGFR) <20 mL/min/1.73 m2. Logistic regression analysis was performed to analyze the effect of ABO-I on the incidence of SGF. Results: The characteristics between the ABO-C and ABO-I were not different. ABO-I received rituximab and plasma exchange. Patients also received tacrolimus and mycophenolate mofetil for 2 weeks and prednisolone for 1 week before transplantation as preconditioning. Of the 95 study patients, 19 (20%) and 21 (22%) were identified with SGF according to POD 3 serum creatinine level or eGFR, respectively. Multivariable analysis revealed that ABO-I significantly reduced the incidence of SGF (odds ratio, 0.15; 95% confidence interval, 0.03-0.7; P = .02), and cold ischemic time >150 min increased the incidence of SGF (odds ratio, 6.5; 95% confidence interval, 1.7-25; P = .006). Similar results were identified in POD 3 eGFR. Inferior graft function in patients with SGF was identified up to 6 months after transplantation. Conclusion: ABO-I reduces the incidence of SGF, which is associated with an inferior graft function up to 6 months.
AB - Background: We investigated the association between ABO-incompatible (ABO-I) kidney transplantation and early graft function. Methods: We retrospectively analyzed 95 patients who underwent living donor kidney transplantation between May 2009 and July 2019. It included 61 ABO-compatible (ABO-C) and 34 ABO-I transplantations. We extracted data on immunologic profile, sex, age, cold ischemic time, type of immunosuppression, and graft function. Two definitions were used for slow graft function (SGF) as follows: postoperative day (POD) 3 serum creatinine level >3 mg/dL and estimated glomerular filtration rate (eGFR) <20 mL/min/1.73 m2. Logistic regression analysis was performed to analyze the effect of ABO-I on the incidence of SGF. Results: The characteristics between the ABO-C and ABO-I were not different. ABO-I received rituximab and plasma exchange. Patients also received tacrolimus and mycophenolate mofetil for 2 weeks and prednisolone for 1 week before transplantation as preconditioning. Of the 95 study patients, 19 (20%) and 21 (22%) were identified with SGF according to POD 3 serum creatinine level or eGFR, respectively. Multivariable analysis revealed that ABO-I significantly reduced the incidence of SGF (odds ratio, 0.15; 95% confidence interval, 0.03-0.7; P = .02), and cold ischemic time >150 min increased the incidence of SGF (odds ratio, 6.5; 95% confidence interval, 1.7-25; P = .006). Similar results were identified in POD 3 eGFR. Inferior graft function in patients with SGF was identified up to 6 months after transplantation. Conclusion: ABO-I reduces the incidence of SGF, which is associated with an inferior graft function up to 6 months.
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U2 - 10.1016/j.transproceed.2021.03.043
DO - 10.1016/j.transproceed.2021.03.043
M3 - Article
C2 - 33931247
AN - SCOPUS:85108338748
SN - 0041-1345
VL - 53
SP - 1494
EP - 1500
JO - Transplantation Proceedings
JF - Transplantation Proceedings
IS - 5
ER -