Impact of ABO incompatible kidney transplantation on living donor transplantation

Korean Organ Transplantation Registry Study Group

doi:10.1371/journal.pone.0173878

Impact of ABO incompatible kidney transplantation on living donor transplantation

Korean Organ Transplantation Registry Study Group

Department of Surgery

Research output: Contribution to journal › Article › peer-review

22 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Result: 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. Conclusions: ABOi-KT increased overall living donor KT, and ABOi-KT from spousal donor is rapidly increasing with favorable clinical outcomes.

Original language	English
Article number	e0173878
Journal	PloS one
Volume	12
Issue number	3
DOIs	https://doi.org/10.1371/journal.pone.0173878
Publication status	Published - 2017 Mar

Bibliographical note

Publisher Copyright:
© 2017 Yu et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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@article{3d6741a3f18b456ebd079ba84e1160de,

title = "Impact of ABO incompatible kidney transplantation on living donor transplantation",

abstract = "Background: 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. Methods: 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. Result: 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. Conclusions: ABOi-KT increased overall living donor KT, and ABOi-KT from spousal donor is rapidly increasing with favorable clinical outcomes.",

author = "{Korean Organ Transplantation Registry Study Group} and Yu, {Ji Hyun} and Chung, {Byung Ha} and Yang, {Chul Woo} and Curie Ahn and Koo, {Tai Yeon} and Jeong, {Jong Cheol} and Jaeseok Yang and Choi, {Bum Soon} and Kim, {Myung Gyu} and Kim, {Yu Seun} and Kim, {Myung Soo} and Kwon, {Oh Jung} and Kim, {Sung Joo} and Kim, {Yeong Hoon} and Choi, {Soo Jin Na} and Chung, {Sang Young} and Cho, {Won Hyun}",

note = "Publisher Copyright: {\textcopyright} 2017 Yu et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2017",

month = mar,

doi = "10.1371/journal.pone.0173878",

language = "English",

volume = "12",

journal = "PloS one",

issn = "1932-6203",

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T1 - Impact of ABO incompatible kidney transplantation on living donor transplantation

AU - Korean Organ Transplantation Registry Study Group

AU - Yu, Ji Hyun

AU - Chung, Byung Ha

AU - Yang, Chul Woo

AU - Ahn, Curie

AU - Koo, Tai Yeon

AU - Jeong, Jong Cheol

AU - Yang, Jaeseok

AU - Choi, Bum Soon

AU - Kim, Myung Gyu

AU - Kim, Yu Seun

AU - Kim, Myung Soo

AU - Kwon, Oh Jung

AU - Kim, Sung Joo

AU - Kim, Yeong Hoon

AU - Choi, Soo Jin Na

AU - Chung, Sang Young

AU - Cho, Won Hyun

N1 - Publisher Copyright: © 2017 Yu et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2017/3

Y1 - 2017/3

N2 - Background: 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. Methods: 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. Result: 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. Conclusions: ABOi-KT increased overall living donor KT, and ABOi-KT from spousal donor is rapidly increasing with favorable clinical outcomes.

AB - Background: 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. Methods: 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. Result: 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. Conclusions: ABOi-KT increased overall living donor KT, and ABOi-KT from spousal donor is rapidly increasing with favorable clinical outcomes.

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DO - 10.1371/journal.pone.0173878

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VL - 12

JO - PloS one

JF - PloS one

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ER -

Impact of ABO incompatible kidney transplantation on living donor transplantation

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