Impact of sensitization and ABO blood types on the opportunity of deceased-donor kidney transplantation with prolonged waiting timeopen access
- Authors
- Lee, Jin Hyeog; Koo, Tai Yeon; Lee, Jung Eun; Oh, Kook Hwan; Kim, Beom Seok; Yang, Jaeseok
- Issue Date
- Feb-2024
- Publisher
- NATURE PORTFOLIO
- Citation
- Scientific Reports, v.14, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- Scientific Reports
- Volume
- 14
- Number
- 1
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65556
- DOI
- 10.1038/s41598-024-53157-2
- ISSN
- 2045-2322
- Abstract
- The waiting time to deceased-donor kidney transplantation (DDKT) is long in Asian countries. We investigated the impact of sensitization and ABO blood type (ABO) on DDKT opportunity using two Korean cohorts: a hospital cohort from two centers and a national database. The impact of panel reactive antibody (PRA) based on the maximal PRA% and ABO on DDKT accessibility was analyzed using a competing risks regression model. In the hospital cohort (n = 4722), 88.2%, 8.7%, and 3.1% of patients belonged to < 80%, 80-99%, and >= 99% PRA groups, respectively, and 61.1%, 11.6%, and 27.3% belonged to A or B, AB, and O blood types, respectively. When PRA and ABO were combined, PRA < 80%/A or B and 80 <= PRA < 99%/AB had fewer DDKT opportunities (median, 12 years; subdistribution hazard ratio [sHR], 0.71) compared with PRA < 80%/AB (median, 11 years). Also, PRA < 80%/O, 80 <= PRA < 99%/A or B, and PRA >= 99%/AB had a much lower DDKT opportunity (median, 13 years; sHR, 0.49). Furthermore, 80 <= PRA < 99%/O and PRA >= 99%/non-AB had the lowest DDKT opportunity (sHR, 0.28). We found similar results in the national cohort (n = 18,974). In conclusion, an integrated priority system for PRA and ABO is needed to reduce the inequity in DDKT opportunities, particularly in areas with prolonged waiting times.
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