The First ABO Incompatible Kidney Transplantation from Living Donor in Slovakia - A Challenge How to Expand the Kidney Donor Pool

Kidney transplantation is the most effective and cheapest treatment for terminal kidney failure. The transplantation programme is limited by the shortage of organs from deceased donors, therefore in many countries and in Slovakia a complementary programme of kidney transplantation from living donors has been established for years. Until recently, in addition to a negative cross-examination, an important condition for kidney transplantation was compatibility in the ABO system, but the development of elimination methods ensuring the removal of specific isoagglutinins and the availability of immunomodulatory and biologic drugs affecting the production of antibodies have made it possible to overcome the ABO barrier and safely transplant kidneys from ABO incompatible living donors. These transplantations offer hope, especially to those patients who have an ABO incompatible donor but have failed a kidney exchange program. We present a case of the first ABO incompatible living donor kidney transplantation in Slovakia, where a patient with blood group O received a kidney from his father with blood group B after desensitization preparation. The chances of success in the kidney exchange programme in the Slovak database were minimal. The aim of this case report is to draw attention to ABO incompatible living donor transplantation, which have the potential to increase the number of living donor kidney transplantation, including pre-emptive transplantation, and to reduce the waiting time for kidney transplantation in patients who do not have a living donor.