ABO-incompatible kidney transplantation in perspective of deceased donor transplantation and induction strategies: a propensity-matched analysis

被引：16

作者：

de Weerd, Annelies E. ^{[1
]}

van den Brand, Jan A. J. G. ^{[2
]}

Bouwsma, Hanneke ^{[3
,4
]}

de Vries, Aiko P. J. ^{[3
,4
]}

Dooper, Ine M. M. ^{[2
]}

Sanders, Jan-Stephan F. ^{[5
]}

Christiaans, Maarten H. L. ^{[6
]}

van Reekum, Franka E. ^{[7
]}

van Zuilen, Arjan D. ^{[7
]}

Bemelman, Frederike J. ^{[8
]}

Nurmohamed, Azam S. ^{[8
]}

van Agteren, Madelon ^{[1
]}

Betjes, Michiel G. H. ^{[1
]}

de Jong, Margriet F. C. ^{[5
]}

Baas, Marije C. ^{[2
]}

机构：

[1] Univ Med Ctr Rotterdam, Erasmus MC Transplant Inst, Dept Internal Med, Rotterdam, Netherlands

[2] Radboud Univ Nijmegen, Radboud Inst Hlth Sci, Dept Nephrol, Med Ctr, Nijmegen, Netherlands

[3] LUMC Leiden Univ, Dept Nephrol, Med Ctr, Leiden, Netherlands

[4] LUMC Leiden Univ, Leiden Transplant Ctr, Med Ctr, Leiden, Netherlands

[5] Univ Med Ctr Groningen, Dept Nephrol, Groningen, Netherlands

[6] Maastricht Univ, Dept Nephrol, Med Ctr, Maastricht, Netherlands

[7] Univ Utrecht, Dept Nephrol, Med Ctr, Utrecht, Netherlands

[8] Univ Amsterdam, Dept Nephrol, Med Ctr, Amsterdam, Netherlands

来源：

TRANSPLANT INTERNATIONAL | 2021年 / 34卷 / 12期

关键词：

ABO-incompatible kidney transplantation; alemtuzumab; deceased donor transplantation; living donor transplantation; patient and graft survival; rejection; ANTIGEN-SPECIFIC IMMUNOADSORPTION; HIGHLY SENSITIZED PATIENTS; RENAL-TRANSPLANTATION; RITUXIMAB; SURVIVAL; OUTCOMES; BARRIER;

D O I：

10.1111/tri.14145

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Kidney transplant candidates are blood group incompatible with roughly one out of three potential living donors. We compared outcomes after ABO-incompatible (ABOi) kidney transplantation with matched ABO-compatible (ABOc) living and deceased donor transplantation and analyzed different induction regimens. We performed a retrospective study with propensity matching and compared patient and death-censored graft survival after ABOi versus ABOc living donor and deceased donor kidney transplantation in a nationwide registry from 2006 till 2019. 296 ABOi were compared with 1184 center and propensity-matched ABOc living donor and 1184 deceased donor recipients (matching: recipient age, sex, blood group, and PRA). Patient survival was better compared with deceased donor [hazard ratio (HR) for death of HR 0.69 (0.49-0.96)] and non-significantly different from ABOc living donor recipients [HR 1.28 (0.90-1.81)]. Rate of graft failure was higher compared with ABOc living donor transplantation [HR 2.63 (1.72-4.01)]. Rejection occurred in 47% of 140 rituximab versus 22% of 50 rituximab/basiliximab, and 4% of 92 alemtuzumab-treated recipients (P < 0.001). ABOi kidney transplantation is superior to deceased donor transplantation. Rejection rate and graft failure are higher compared with matched ABOc living donor transplantation, underscoring the need for further studies into risk stratification and induction therapy [NTR7587, ].

引用

页码：2706 / 2719

页数：14

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