Introduction: 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 long-term comparative data regarding patient and graft survival, graft function, and complications in Korean patients receiving ABO-compatible (ABOc) and ABOi kidney transplants (KT).
Material andMethods: This retrospective study compared 35 consecutive ABOi living donor KTs with 138 ABOc living donor KTs using same maintaining immunosuppressive regimens and all patents were followed up more than 5-year. We examined preoperative demographic factors, immunologic risk factors, and patient & graft survivals until 5 years after transplantation, postoperative renal function, acute rejection episodes, infections, medical and surgical complications, duration of hospital stay as well as cause for readmission, and their rates by 2 years after transplantation.
Results: Patient survival was similar between the ABOc and ABOi group (97.8% vs 94.2% at 1 year, 97.1% vs 94.3% at 3 years, and 97.1% vs 94.2% at 5 years; P=.108). Graft survival also comparable between ABOc group (96.4%, 94.8%, and 94.2% at 1, 3, and 5 years) and ABOi group (91.4%, 91.4% and 91.4% at 1,3, and 5 years; P=.334). There were no significant differences in terms of and graft function until 2 years after transplantation. Acute antibody mediated rejection episodes, bleeding complications, BK virus infections, and preoperative hospital stay were significantly greater in the ABOi group by 2 years after trnasplatation (P = .001, P = .002, P = .005, and P < .001 respectively).
Discussion. We concluded that, despite some disadvantages, ABOi KT is a viable, safe option for patients whose only available donor is blood group incompatible