Impact of ABO incompatible kidney transplantation on living donor transplantation

ABO incompatible kidney transplantation (ABOi-KT) is an important approach for overcoming donor shortages. We evaluated the effect of ABOi-KT on living donor KT. Two nationwide transplantation databases were used. We evaluated the impact of ABOi-KT on overall living donor transplant activity and spo...

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Published in:PloS one 2017-03, Vol.12 (3), p.e0173878-e0173878
Main Authors: Yu, Ji Hyun, Chung, Byung Ha, Yang, Chul Woo
Format: Article
Language:English
Subjects:
ABO Blood-Group System
ABO system
Adult
Analysis
Biology and Life Sciences
Biopsy
Blood Group Incompatibility
Blood groups
Clinical outcomes
Databases, Factual
Drug dosages
Failure analysis
Female
Glomerular Filtration Rate
Graft rejection
Graft Survival
Hazards
Health aspects
Humans
Immunoglobulins
Incompatibility
Internal medicine
Kidney transplantation
Kidney Transplantation - adverse effects
Kidney Transplantation - methods
Kidney transplants
Living Donors
Male
Medicine
Medicine and Health Sciences
Middle Aged
Multivariate analysis
Nephrology
Patients
Physical Sciences
Proportional Hazards Models
Regression analysis
Rejection
Republic of Korea
Research and Analysis Methods
Risk analysis
Risk Factors
Shortages
Spouses
Tissue donation
Transplantation
Transplants & implants
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Chung, Byung Ha
Yang, Chul Woo
description ABO incompatible kidney transplantation (ABOi-KT) is an important approach for overcoming donor shortages. We evaluated the effect of ABOi-KT on living donor KT. Two nationwide transplantation databases were used. We evaluated the impact of ABOi-KT on overall living donor transplant activity and spousal donation as subgroup analysis. In addition, we compared the clinical outcome between ABOi-KT and ABO compatible KT (ABOc-KT) from spousal donor, and performed a Cox proportional hazards regression analysis to define the risk factors affecting the allograft outcomes. The introduction of ABOi-KT increased overall living donor KT by 12.2% and its portion was increased from 0.3% to 21.7% during study period. The ABOi-KT in living unrelated KT was two times higher than that of living related donor KT (17.8 vs.9.8%). Spousal donor was a major portion of living unrelated KT (77.6%) and ABOi-KT increased spousal donation from 10% to 31.5% in living donor KT. In addition, increasing rate ABOi-KT from spousal donor was 10 times higher than that of living related donor. The clinical outcome (incidence of acute rejection, allograft function, and allograft and patient survival rates) of ABOi-KT from spousal donor was comparable to that of ABOc-KT. Neither ABO incompatibility nor spousal donor was associated with acute rejection or allograft failure on multivariate analysis. ABOi-KT increased overall living donor KT, and ABOi-KT from spousal donor is rapidly increasing with favorable clinical outcomes.
doi_str_mv 10.1371/journal.pone.0173878
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We evaluated the effect of ABOi-KT on living donor KT. Two nationwide transplantation databases were used. We evaluated the impact of ABOi-KT on overall living donor transplant activity and spousal donation as subgroup analysis. In addition, we compared the clinical outcome between ABOi-KT and ABO compatible KT (ABOc-KT) from spousal donor, and performed a Cox proportional hazards regression analysis to define the risk factors affecting the allograft outcomes. The introduction of ABOi-KT increased overall living donor KT by 12.2% and its portion was increased from 0.3% to 21.7% during study period. The ABOi-KT in living unrelated KT was two times higher than that of living related donor KT (17.8 vs.9.8%). Spousal donor was a major portion of living unrelated KT (77.6%) and ABOi-KT increased spousal donation from 10% to 31.5% in living donor KT. In addition, increasing rate ABOi-KT from spousal donor was 10 times higher than that of living related donor. 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We evaluated the effect of ABOi-KT on living donor KT. Two nationwide transplantation databases were used. We evaluated the impact of ABOi-KT on overall living donor transplant activity and spousal donation as subgroup analysis. In addition, we compared the clinical outcome between ABOi-KT and ABO compatible KT (ABOc-KT) from spousal donor, and performed a Cox proportional hazards regression analysis to define the risk factors affecting the allograft outcomes. The introduction of ABOi-KT increased overall living donor KT by 12.2% and its portion was increased from 0.3% to 21.7% during study period. The ABOi-KT in living unrelated KT was two times higher than that of living related donor KT (17.8 vs.9.8%). Spousal donor was a major portion of living unrelated KT (77.6%) and ABOi-KT increased spousal donation from 10% to 31.5% in living donor KT. In addition, increasing rate ABOi-KT from spousal donor was 10 times higher than that of living related donor. 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We evaluated the effect of ABOi-KT on living donor KT. Two nationwide transplantation databases were used. We evaluated the impact of ABOi-KT on overall living donor transplant activity and spousal donation as subgroup analysis. In addition, we compared the clinical outcome between ABOi-KT and ABO compatible KT (ABOc-KT) from spousal donor, and performed a Cox proportional hazards regression analysis to define the risk factors affecting the allograft outcomes. The introduction of ABOi-KT increased overall living donor KT by 12.2% and its portion was increased from 0.3% to 21.7% during study period. The ABOi-KT in living unrelated KT was two times higher than that of living related donor KT (17.8 vs.9.8%). Spousal donor was a major portion of living unrelated KT (77.6%) and ABOi-KT increased spousal donation from 10% to 31.5% in living donor KT. In addition, increasing rate ABOi-KT from spousal donor was 10 times higher than that of living related donor. The clinical outcome (incidence of acute rejection, allograft function, and allograft and patient survival rates) of ABOi-KT from spousal donor was comparable to that of ABOc-KT. Neither ABO incompatibility nor spousal donor was associated with acute rejection or allograft failure on multivariate analysis. ABOi-KT increased overall living donor KT, and ABOi-KT from spousal donor is rapidly increasing with favorable clinical outcomes.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28323892</pmid><doi>10.1371/journal.pone.0173878</doi><tpages>e0173878</tpages><orcidid>https://orcid.org/0000-0001-9796-636X</orcidid><oa>free_for_read</oa></addata></record>
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1932-6203
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source Publicly Available Content Database (Proquest) (PQ_SDU_P3); PubMed Central
subjects ABO Blood-Group System
ABO system
Adult
Analysis
Biology and Life Sciences
Biopsy
Blood Group Incompatibility
Blood groups
Clinical outcomes
Databases, Factual
Drug dosages
Failure analysis
Female
Glomerular Filtration Rate
Graft rejection
Graft Survival
Hazards
Health aspects
Humans
Immunoglobulins
Incompatibility
Internal medicine
Kidney transplantation
Kidney Transplantation - adverse effects
Kidney Transplantation - methods
Kidney transplants
Living Donors
Male
Medicine
Medicine and Health Sciences
Middle Aged
Multivariate analysis
Nephrology
Patients
Physical Sciences
Proportional Hazards Models
Regression analysis
Rejection
Republic of Korea
Research and Analysis Methods
Risk analysis
Risk Factors
Shortages
Spouses
Tissue donation
Transplantation
Transplants & implants
title Impact of ABO incompatible kidney transplantation on living donor transplantation
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