Outcomes of ABO-incompatible kidney transplantation in older patients: a national cohort study
- Authors
- Kim, Deok Gie; Lee, Juhan; Kim, Myoung Soo; Kwon, Oh Jung; Jung, Cheol Woong; Lee, Kang Wook; Yang, Jaeseok; Ahn, Curie; Huh, Kyu Ha; Korean Organ Transplantation Registry Study Group
- Issue Date
- Feb-2021
- Publisher
- Blackwell Publishing Inc.
- Keywords
- ABO-; incompatible; kidney transplantation; older
- Citation
- Transplant International, v.34, no.2, pp 290 - 301
- Pages
- 12
- Indexed
- SCIE
SCOPUS
- Journal Title
- Transplant International
- Volume
- 34
- Number
- 2
- Start Page
- 290
- End Page
- 301
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/51658
- DOI
- 10.1111/tri.13794
- ISSN
- 0934-0874
1432-2277
- Abstract
- Background
Outcomes of ABO-incompatible living donor kidney transplantation (ABOi LDKT) in older individuals have not been established.
Methods
This multicentric observational study, using data from the Korean Organ Transplantation Registry database, included 634 older patients (≥60 years) undergoing kidney transplantation. We compared clinical outcomes of ABOi LDKT (n = 80) with those of ABO-compatible LDKT (ABOc LDKT, n = 222) and deceased donor kidney transplantation (DDKT, n = 332) in older patients.
Results
Death-censored graft survival was similar between the three groups (P = 0.141). Patient survival after ABOi LDKT was similar to that after ABOc LDKT (P = 0.489) but higher than that after DDKT (P = 0.038). In multivariable analysis, ABOi LDKT was not risk factor (hazard ratio [HR] 1.73, 95% confidence interval [CI] 0.29-10.38, P = 0.548), while DDKT was significant risk factor (HR 3.49, 95% CI 1.01–12.23, P = 0.049) for patient survival. Although ABOi LDKT showed higher biopsy-proven acute rejection than ABOc LDKT, the difference was not significant after adjustment with covariates. However, ABOi LDKT was significant risk factor for infection (HR 1.66, 95% CI 1.12–2.45, P = 0.012).
Conclusions
In older patients, ABOi LDKT was not inferior to ABOc LDKT and was superior to DDKT for patient survival. ABOi LDKT can be recommended for older patients, rather than waiting for DDKT.
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- Appears in
Collections - 2. Clinical Science > Department of Transplantation and Vascular Surgery > 1. Journal Articles
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