Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: ABO-incompatible (ABOi) and positive crossmatch (XM) kidney transplantation (KT) have been considered immunologically challenging. The present study analyzed the clinical outcomes in XM positive KT based on ABO incompatibility.
*Methods: We used data from the Korea Organ Transplantation Registry, a nationwide database, and a single-center registry. A total of 263 patients with positive XM were divided into an ABO compatible (ABOc) & XM positive (ABOc/XM+, n=176) group and an ABOi & XM positive (ABOi/XM+, n=87) group.
*Results: The overall rejection rate one year after KT was significantly higher in the ABOi/XM+ group than in the ABOc/XM+ group (P < 0.01). A total of four mortalities occurred, all in the ABOi/XM+ patients (P < 0.01). There were no differences in surgical complications or the occurrence of infection-related complications, including BK virus nephropathy. Multivariate analysis indicated that female vs. male (odds ratio (OR), 2.27; P = 0.03), DSA class I (MFI/1000) (OR, 1.10; P = 0.03), DSA class II (MFI/1000) (OR, 1.10; P < 0.01), and ABOi & XM+ status (OR, 2.38; P < 0.01) were significant risk factors for acute rejection during the year after transplantation. Overall graft survival was inferior in ABOi/XM+ patients than in ABOc/XM+ patients (P = 0.02).
*Conclusions: ABO incompatibility in XM-positive KT patients was found to be a significant risk factor for the development of rejection within one year after transplantation as well as for long-term graft survival. The anti-blood group A, B and anti-HLA antibodies may show synergistic activity.
|CDC positive||14 (8.0)||8 (9.2)||0.91|
|FCXM positive||162 (92.0)||79 (90.8)||0.89|
|DSA class I (MFI)||5486 ± 4356||3705 ± 4654||0.09|
|DSA class II (MFI)||5088 ± 5522||5209 ± 5576||0.93|
|Overall rejection||21 (11.7)||25 (25.5)||<0.01|
|ACR only||5 (2.8)||6 (6.1)||0.17|
|AMR with or without ACR||16 (8.9)||19 (19.4)||0.01|
To cite this abstract in AMA style:Kwon H, Ko Y, Han D. Effect of Simultaneous Presence of Anti-Blood Group A/B and -HLA Antibodies on Clinical Outcomes in Kidney Transplantation Across Positive Crossmatch: A Nationwide Cohort Study [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-simultaneous-presence-of-anti-blood-group-a-b-and-hla-antibodies-on-clinical-outcomes-in-kidney-transplantation-across-positive-crossmatch-a-nationwide-cohort-study/. Accessed July 23, 2021.
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