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2012 ; 26
(3
): 489-94
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English Wikipedia
Underutilization of A2 ABO incompatible kidney transplantation
#MMPMID22032287
Redfield RR
; Parsons RF
; Rodriguez E
; Mustafa M
; Cassuto J
; Vivek K
; Noorchashm H
; Naji A
; Levine MH
; Abt PL
Clin Transplant
2012[May]; 26
(3
): 489-94
PMID22032287
show ga
BACKGROUND: ABO compatibility creates a disadvantage for O and B renal allograft
candidates. A2 ABO incompatible transplant may decrease waiting times and
generate equivalent graft survival to an ABO compatible transplant. METHODS:
Death-censored graft survival was compared between A recipients and O, B, and AB
recipients of an A2 allograft with multivariate Cox regression models utilizing
data from the United Network of Organ Sharing (UNOS) between 1997 and 2007.
RESULTS: Eighty-five percent of A2 kidneys were transplanted into ABO compatible
recipients vs. 15% into ABO incompatible recipients. Rates of A2 incompatible
kidney transplants did not increase over the study period (14.8% to 14.6%). Mean
wait time for A2?O kidneys was 337 vs. 684 d for O?O and for A2?B kidneys, 542
vs. 734 d for B?B. Adjusted relative risk of graft loss at five-yr was similar
between O, B, and AB recipients compared to A recipients of an A2 allograft,
corresponding to a five-yr graft survival of 84%, 86.2%, 86.1%, and 86.1%,
respectively. CONCLUSION: A2 incompatible kidney transplantation is
underutilized. Graft outcomes are similar among A2 compatible and incompatible
recipients. Shorter waiting time and improved access might be achieved if A2
kidneys are considered in all blood groups.
|*Transplantation Immunology
[MESH]
|ABO Blood-Group System/*immunology
[MESH]
|Adult
[MESH]
|Blood Group Incompatibility/*immunology
[MESH]
|Female
[MESH]
|Follow-Up Studies
[MESH]
|Graft Survival/*immunology
[MESH]
|Humans
[MESH]
|Kidney Failure, Chronic
[MESH]
|Kidney Transplantation/*immunology/mortality/*statistics & numerical data
[MESH]