Backgound: The aim of this study was to overview experience of pioneer living-donor incompatible blood group (AB0i) kidney transplantation in Lithuania; to compare allograft outcomes with a control group of compatible blood group (AB0c) kidney transplantation.
Methods: We retrospectively analysed outcome data of 11 patients who underwent AB0i kidney transplantation between January 2010 and November, 2014 in Vilnius University Hospital Santaros Clinics. Data was colected from January, 2010 until November, 2016. Estimated glomerular filtration rate (eGFR), proteinuria after transplantation was evaluated and compared to the graft function of 28 patients who had AB0c kidney transplantations during the same period.
Results: The analysis included 39 kidney transplant from a living donor. 10 out of 11 AB0i recipients AB0i reached the target of <1:8 IgG titer after antigen-specific imunoadsorbtion with multiple personal use “AB0 Adsopak” columns, plasmapheresis or no antibody removal procedure (2 patients) and rituximab infusion. AB0i group had no statistically significant difference in eGFR at 0.5 yr, 1 yr, 2 yrs after transplantation (according to the CKD-EPI formula p=0.16, p=0.22, p=0.000892, p=0.27, respectively). We found no statistically significant difference between groups in all periods of proteinuria (p > 0.05), in graft survival (AB0i 9%, AB0c 14%; p=0.66). Also there was no significant difference in number of patients for whom rejection was detected (AB0i 9%, AB0c 28.6%; p=0.19) or in duration of renal replacement therapy before transplantation (p=0.26).
Conclusions: AB0i kidney transplantation is as effective as AB0c kidney transplantation in patient with end-stage renal disease.