Clin Transplant Res.  2024 Sep;38(3):197-202. 10.4285/ctr.24.0028.

Perioperative outcomes of 105 cases of ABO-incompatible live donor kidney transplantation: a retrospective single-center observational study

• Shekhrajka P
• Mandal S
• Goyal VK
• Mittal S
• Khunteta N
• Mishra A

• KMID: 2559806
• DOI: http://doi.org/10.4285/ctr.24.0028

Abstract

Background
ABO-incompatible (ABOi) kidney transplantation poses significant challenges in achieving successful outcomes. This study aimed to investigate the impact of various interventions and techniques on improving the success rates of ABOi kidney transplantation.
Methods
We conducted a retrospective observational analysis of patients who underwent ABOi kidney transplantation from November 2012 to March 2023. The study included a total of 105 patients. We collected and analyzed data on patient demographics, preoperative assessments, surgical details, and postoperative outcomes.
Results
The mean ages of the donors and recipients were 50.52±10.32 and 36.63±11.61 years, respectively. The majority of recipients were male (81.9%), while most donors were female (89.5%). The most common blood group among recipients was O (69.5%), and among donors, it was B (46.7%). The median durations of chronic kidney disease and dialysis were 12 months (interquartile range [IQR], 7–28 months) and 6 months (IQR, 2–12 months), respectively. Baseline antibody titers (anti-A and anti-B) ranged from 64.0 to 256.0, while on the day of surgery, they were ≤8. Perioperative complications in-cluded hypotension (10.5%), acute tubular necrosis (5.7%), delayed graft function (3.8%), and reexploration (3.8%) due to hematoma.
Conclusions
ABOi kidney transplantation is a viable option for recipients lacking available donors with an ABO-compatible match. Perioperative concerns, including hypoalbuminemia, heightened risk of infections, coagulopathies, aseptic precautions, and immunological surveillance, must be carefully addressed.

Keyword

Kidney transplantation; Blood group incompatibility; Transplantation; Delayed graft function; Acute kidney tubular necrosis

Figure

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  Fig. 1 Study design. ABOc, ABO-compatible; ABOi, ABO-incompatible; HLAi, human leukocyte antigen-incompatible.

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  Fig. 2 Perioperative complications. AF, atrial fibrillation; ATN, acute tubular necrosis; DGF, delayed graft function.

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