Overcoming the ABO incompatibility barrier in living donor kidney transplantation

Aim. Analysis of the results of living-related ABO-incompatible kidney transplantations (iABO) and comparison with results of ABO-compatible kidney transplantations from living-related (LD) and deceased donors (DD). Materials and Methods. 279 patients underwent kidney transplantations at our center between January 2011 and June 2013. The patients were divided into three groups: iABO (n = 15), LD (n = 114) and DD (n = 150). Patients from the iABO group underwent pre-transplant desensitization: Rituximab + Plasmapheresis / Immunoadsorption + High-dose IvIg. Maintenance immunosuppression was the same in all three groups: tacrolimus/cyclosporine A + MMF/ mycophenolic acid + steroids. Results. Medians of follow-up perion in the iABO, LD and DD groups were 13, 15 and 12 months, respectively. No death cases occurred in the iABO and LD groups. In the DD group five patients (3,3%) died on different times after Tx. Biopsy-proven acute rejection rate in iABO group was 13,3% and there were no significant differences in comparison with LD group (6,1%, p = 0,3040) and DD group (9,3%, p = 0,6177). One- and two-year graft survival in groups was 91,7% and 91,7% – iABO; 97,3% and 93,1% – LD; 87,5% and 87,5% – DD. No significant differences in graft survival between iABO vs LD (log-rank test p = 0,6938) and between iABO vs DD (log-rank test p = 0,4868) were found. Conclusion. The overcoming the ABO incompatibility barrier in living donor kidney transplantation is perspective trend in transplantology. It is perspective option for increase, at first, the pool of the living donors, and the access for kidney transplantation. The results of ABO-incompatible are non-inferior than in LD group.

трансплантация почки, несовместимость по группе крови, kidney transplantation, blood group incompatibility

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