• Users Online: 424
  • Print this page
  • Email this page
ORIGINAL ARTICLE
Year : 2022  |  Volume : 16  |  Issue : 1  |  Page : 56-60

Clinical outcome of ABO-Incompatible kidney transplant with low baseline anti-A/B antibody titer without the use of plasma exchange - A retrospective study


1 Department of Nephrology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
2 Department of Urology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
3 Department of Transfusion Medicine, Aditya Birla Memorial Hospital, Pune, Maharashtra, India

Correspondence Address:
Dr. Tarun Kumar Jeloka
Department of Nephrology, Aditya Birla Memorial Hospital, Pune - 411 033, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijot.ijot_60_21

Rights and Permissions

Background: The outcome of ABO-incompatible (ABOi) transplant (Tx) may be compromised because of the need for added immunosuppression. Many centers still use plasma exchange (PEX) even when anti-A/B titers are low. We compared the outcome of ABOi kidney Tx with low baseline anti-A/B titers without PEX to those with high titers managed with PEX and to ABO-compatible (ABOc) Tx. Materials and Methods: In this retrospective study, all adult kidney Tx done at our institute were eligible. Patients <18 years of age, deceased donor transplant recipients, and those with hepatitis B, C or HIV infections at the time of transplant were excluded from this analysis. Outcomes including biopsy-proven AR, estimated glomerular filtration rate (eGFR) (Modification of Diet in Renal Disease equation), infections, and patient and graft survival were determined in ABOi kidney Tx with low baseline anti-A/B antibody titers managed without PEX (Group A). These outcomes were compared to a contemporary cohort of those with high titers and use of PEX (Group B) and ABOc Tx (Group C). Continuous variables were compared by Student's t-test and categorical variables with Chi-square test. Patient and graft survival was calculated by Kaplan–Meier curve and compared between the groups by log-rank test. Results: Baseline characteristics reveal no difference in recipients and donor factors such as age, gender, and HLA match. Initial immunoglobulin G anti-A/B titers were higher in Group B as compared to Group A (P = 0.04), but final titers pretransplant were similar (P = 0.6). Biopsy-proven rejections were not different between Groups A and B or Groups A and C. Serum creatinine and eGFR at 1 month and at last follow-up were also similar in all the groups. Infections were seen in 22.2% of the patients in Group A, 44.4% in Group B, and 27.7% in Group C. Patient survival and death-censored graft survival were similar in all three groups. Conclusion: This retrospective study shows that patients with low baseline anti-ABO antibodies managed without PEX are safe and have similar outcomes such as patient and graft survival, rejections, infections, and renal function.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed278    
    Printed2    
    Emailed0    
    PDF Downloaded35    
    Comments [Add]    

Recommend this journal