ABO-Incompatible Live Donor Kidney Transplants Inferior to ABO-Compatible Transplants, but Match Deceased Donor Results: Is Kidney Paired Donation the Answer?

J. Verbesey, M. Cooper, A. Gilbert, M. Grafals, P. Weems, J. Moore, S. Ghasemian, C. Nilubol, B. Javaid.

Georgetown University School of Medicine, MedStar Georgetown Transplant Institute, Kidney and Pancreas Transplant Program, Washington, DC.

Meeting: 2015 American Transplant Congress

Abstract number: 39

Keywords: Graft survival, Kidney transplantation, Outcome, Survival

Session Information

Session Name: Concurrent Session: Kidney Complications: Late Graft Failure

Session Type: Concurrent Session

Date: Sunday, May 3, 2015

Session Time: 2:15pm-3:45pm

Presentation Time: 3:15pm-3:27pm

Location: Terrace IV

Objective: Compare kidney allograft survival in ABO-incompatible (ABO-I) and ABO-compatible (ABO-C) live donor kidney transplant recipients.

Methods: We analyzed UNOS database for patients who underwent a kidney transplant between 04/01/2008 and 03/31/2013. Kaplan-Meier and Cox modeling techniques were used to estimate survival.

Results: We identified 74,684 individuals who had their first kidney transplant during the five year period, of which 26,743 had a live donor ABO-C kidney transplant, 410 had live donor ABO-I kidney transplant and 47,531 had a deceased donor kidney transplant either from ABO-C or ABO-I deceased donor. Kidney allograft survival was inferior in ABO-I live donor compared to ABO-C live donor kidney transplant recipients (HR=1.69; 95%CI=1.26-2.28; p=0.0005; adjusted HR=1.64; 95%CI=1.22-2.21; p=0.0010). Graft survival was comparable when comparing ABO-C to ABO-I deceased donor transplants. Data were then compared for recipients of ABO-I live donor kidney transplant recipients to all deceased donor kidney transplant recipients. Graft survival for recipients of deceased donor kidney transplants was comparable to recipients of ABO-I live donor kidney transplants (HR=1.26; 95%CI=0.94-1.69; p=0.1201; adjusted HR=1.27; 95%CI=0.95-1.70; p=0.1108).

Conclusions: In the US national cohort of kidney transplant recipients, allograft survival in ABO-I live donor kidney transplants was inferior to ABO-C live donor kidney transplant recipients. However, kidney allograft survival in ABO-I live donor kidney transplant recipients was comparable to recipients of deceased donor organs. These findings validate our attempts to advocate for ABO-C paired donation prior to resorting to live ABO-I transplants. Kidney paired donation in ABO-I live donor-recipient pairs aimed to facilitate ABO-compatible transplants can improve allograft survival and patient outcomes.

To cite this abstract in AMA style:

Verbesey J, Cooper M, Gilbert A, Grafals M, Weems P, Moore J, Ghasemian S, Nilubol C, Javaid B. ABO-Incompatible Live Donor Kidney Transplants Inferior to ABO-Compatible Transplants, but Match Deceased Donor Results: Is Kidney Paired Donation the Answer? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/abo-incompatible-live-donor-kidney-transplants-inferior-to-abo-compatible-transplants-but-match-deceased-donor-results-is-kidney-paired-donation-the-answer/. Accessed May 19, 2025.

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