Kidney Posters

Monday July 02, 2018 from 16:30 to 17:30

Room: Hall 10 - Exhibition

P.025 Effect of vitamin D deficiency on antibody-mediated rejection (ABMR): a comparative analysis of live-related ABO-incompatible and abo-compatible renal transplantation

Raj Kumar Sharma, India

Head of department
department of nephrology
Sanjay Gandhi Post Graduate Institute of Medical Sciences,

Abstract

Effect of Vitamin D Deficiency on Antibody-Mediated Rejection (ABMR): A Comparative Analysis of Live-Related ABO-Incompatible and ABO-Compatible Renal Transplantation

Raj Kumar Sharma1, Sonia Mehrotra 1, Monika Yachha1, Narayan Prasad1, Amit Gupta1, Dharmendra S. Bhadauria 1, Anupama Kaul1.

1Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

Aims  and  Objectives:  To  compare  the  outcomes  of  Living-Donor  ABO-incompatible  renal  transplantation  (ABO-i)  with  matched  recipients  of  ABO-compatible  (ABOc)  transplantation  in  relation to vitamin D status.
Material  and  Methods: We  retrospectively  analysed  the  results  of  33  ABOi  live-donor  kidney  transplants  (LDKTs)  performed  between  January  2013  and  June  2016 at our centre. We  compared  patient  and  graft  survival,  acute  rejection  episodes, vitamin D status and graft  function of  the  ABO-i  group  with  an  equal  number  of  matched  Live-related ABO-c KTs  done  during  the  same  time-period.
Results: The patient-survival  in  both  the  groups was 97%,  however  death-censored  graft  survival  was  94%  in  the  ABOi  recipients  versus  100%  in  ABOc  group  over  a  mean  follow-up  of  14  to  15  months  respectively. Graft  function  was  overall  better  in  the  ABOc  recipients,  with statistical  significance seen  at  6  and  12  months  post-transplant.  We  also  observed  a  significantly  higher  incidence  of  Acute  Antibody-mediated  rejections  (ABMR)  in  the  ABOi  cohort,  with  11 episodes of ABMR  versus just 2 in the ABOc recipients (p=0.005). Vitamin D deficiency was associated with higher levels of anti ABO antibody and increased development of ABMR due to ABO antibodies (p=0.01).
Conclusion: ABO  incompatible  transplantation is an option with excellent  patient  and  graft  survival; results almost comparable  to  the  ABO  compatible  grafts.  However,  in  our  study  ABOi  transplants  were  associated  with  higher  risk  of  Acute  ABMR.  These  episodes  were  amenable  to  treatment  and  thus  the overall  graft  survival  had  similar  outcomes. Vitamin D deficiency was associated with increased ABMR in ABOi renal transplants.

 



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