Reduced Incidence of Rejection in AB0-incompatible Kidney Transplantation – Five Year Follow-Up in a Single Center.
Nephrology and Hypertension, Universitaet Erlangen-Nuernberg, Erlangen, Germany.
Meeting: 2016 American Transplant Congress
Abstract number: A132
Keywords: CD20, Donors, Kidney transplantation, unrelated, Waiting lists
Session Information
Session Name: Poster Session A: Kidney Donor Outcomes
Session Type: Poster Session
Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Introduction:
Living kidney donation is the method of choice to expand the donor pool in times of severe organ shortage. In many centers, AB0-incompatible kidney transplantation (AB0i-KTx) has been increasingly employed during the last decades to further decrease waiting time. However, long term outcome data in comparison to AB0-compatible kidney transplantation (AB0c-KTx) remains limited. The aim of the study was to analyze the long-term results of over 40 AB0i-KTx performed at our center since 2006 in comparison to AB0c-KTx.
Methods:
Retrospective single center analysis of AB0-incompatible living donor kidney transplants compared to matched AB0-compatible living kidney donor transplants of the same era. Our protocol for ABO-incompatible kidney transplantation is based on antigen-specific immunoadsorption and rituximab, in combination with standard maintenance immunosuppression. Pairs were matched for HLA-mismatches, donor and recipient age. Rejections were defined as biopsy proven rejections (cellular and humoral) more severe than borderline lesions. Infectious complications were defined as sepsis, urosepsis or recurrent (>3 within a year) urinary tract infections. CMV and BKV complications were defined as viremia or infections with organ manifestations.
Results:
41 patients with AB0-incompatible and 47 patients with AB0-compatible living donor kidney transplantation were followed for a mean of 1380 ± 70 and 1274 ± 78 days respectively. Renal function was not significantly different between the groups up to 5 years after transplantation AB0i-KTx (1.8 mg/dl ± 0.3 (n=14) vs. 1.9 mg/dl ± 0.4 (n=9). Biopsy proven rejections (cellular and humoral combined) were significantly less frequent in the AB0-incompatible group (p=0.005, log-rank test). Infectious complications such as CMV, BKV and bacterial infections were not significantly different between groups indicating a comparable safety profile of the procedure.
Discussion:
Our retrospective single-center analysis indicates that AB0-incompatible renal transplantation shows significantly less rejection episodes compared to matched controls. Whether this is the result of anti-CD20 therapy in AB0i-KTx remains to be investigated. Overall, AB0i-KTx is safe and successful and therefore represents a valuable option to expand the donor pool for waitlisted patients.
CITATION INFORMATION: Weidemann A, Karpf F, Dienemann T, Birkner K, Jacobi J, Eckardt K.-U. Reduced Incidence of Rejection in AB0-incompatible Kidney Transplantation – Five Year Follow-Up in a Single Center. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Weidemann A, Karpf F, Dienemann T, Birkner K, Jacobi J, Eckardt K-U. Reduced Incidence of Rejection in AB0-incompatible Kidney Transplantation – Five Year Follow-Up in a Single Center. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/reduced-incidence-of-rejection-in-ab0-incompatible-kidney-transplantation-five-year-follow-up-in-a-single-center/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress