Clinical Outcomes and Results of Pathological Findings of 1-year Protocol Biopsy in Recipients of ABO-Incompatible Living Donor Kidney Transplantants

Yokoyama, T.; Konno, Osamu; Kihara, Y.; Nakamura, Yuki; Iwamoto, Hitoshi; Kawa, Shigeyuki

doi:10.1016/j.transproceed.2016.02.043

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…Few studies have con rmed the therapeutic effects of SCR treatment by comparing histological ndings from PB at about 2 weeks after transplantation. Although Yokoyama et al conducted a study similar to ours, their enrolled patient group was small; other studies looked at the histological results of PB at 3 and 12 months, but they focused on ABO incompatibility [26][27][28]. We analyzed histological changes in individual patients at two time points, which could have reduced the bias in our study.…”

Section: Discussionmentioning

confidence: 99%

Effects of Treating Subclinical Rejection 2 Weeks after Kidney Transplantation, as Determined by Analyzing 1-Year Histologic Outcomes

Lee

et al. 2022

Preprint

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Background: Subclinical rejection (SCR) is associated with chronic allograft nephropathy. Therefore, early detection and treatment of SCR through a protocol biopsy (PB) can reduce the incidence of pathological changes. This study evaluates the impact of early detection and treatment of subclinical rejection through the use of a routine PB 2 weeks after kidney transplantation (KT) by examining histologic outcomes 1 year later. Methods: We reviewed 624 KT recipients at Samsung Medical Center between August 2012 and December 2018. PB was planned 2 weeks and 1 year after transplantation. We compared the histological changes between the 2 biopsies. After a propensity score matching analysis, we divided the patients into 2 groups: the proven normal group (n = 256) and rejection group (n = 96) at the PB taken 2 weeks post-transplant. Results: The rejection group showed no significant difference from the normal group in the flow of graft function (eGFR) or the Kaplan-Meier curve for graft survival. In the histologic outcomes, the pathological differences between 2 groups showed significantly improved between the two time points. Conclusions: Treating SCR through a PB 2 weeks after KT can contribute to maintenance of graft function and improve histologic changes 1 year after KT.

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Section: Discussionmentioning

confidence: 99%

Effects of Treating Subclinical Rejection 2 Weeks after Kidney Transplantation, as Determined by Analyzing 1-Year Histologic Outcomes

Lee

et al. 2022

Preprint

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“… 23 Furthermore, PLD desire to donate to their intended candidate, rather than participate in KPD, may influence selection. One study reports more HLA mismatches in ABOi compared with ABOc LDKT, 31 which may also contribute to the increased risk of graft loss. Finally, the desire to pursue LDKT rather than wait for ABOc DDKT, as well as PLD desire to donate to their intended candidate, may influence patients and providers to accept an A2i living donor when they would not have accepted a comparable deceased donor.…”

Section: Discussionmentioning

confidence: 99%

Patient and Graft Survival After A1/A2-incompatible Living Donor Kidney Transplantation

Bisen

Getsin

Chiang

et al. 2022

Transplantation Direct

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Background. ABO type B and O kidney transplant candidates have increased difficulty identifying a compatible donor for living donor kidney transplantation (LDKT) and are harder to match in kidney paired donation registries. A2-incompatible (A2i) LDKT increases access to LDKT for these patients. To better inform living donor selection, we evaluated the association between A2i LDKT and patient and graft survival. Methods. We used weighted Cox regression to compare mortality, death-censored graft failure, and all-cause graft loss in A2i versus ABO-compatible (ABOc) recipients. Results. Using Scientific Registry of Transplant Recipients data 2000–2019, we identified 345 A2i LDKT recipients. Mortality was comparable among A2i and ABOc recipients; weighted 1-/5-/10-y mortality was 0.9%/6.5%/24.2%, respectively, among A2i LDKT recipients versus 1.4%/7.7%/22.2%, respectively, among ABOc LDKT recipients (weighted hazard ratio [wHR], 0.811.041.33; P = 0.8). However, A2i recipients faced higher risk of death-censored graft failure; weighted 1-/5-/10-y graft failure was 5.7%/11.6%/22.4% for A2i versus 1.7%/7.5%/17.2% for ABOc recipients (wHR in year 1 = 2.243.565.66; through year 5 = 1.251.782.53; through year 10 = 1.151.552.07). By comparison, 1-/5-/10-y wHRs for A1-incompatible recipients were 0.631.966.08/0.390.942.27/0.390.831.74. Conclusions. A2i LDKT is generally safe, but A2i donor/recipient pairs should be counseled about the increased risk of graft failure and be monitored as closely as their A1-incompatible counterparts posttransplant.

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“…After bleak preliminary results for ABOi LDKT were published(3), concerns for hyper-acute rejection initially stifled further pursuits of incompatible transplantation. Then, during the 1980s, reports of successful ABOi LDKT in Japan (4-6) sparked a renewed interest in the US. Several single-center center studies in the US have since demonstrated equivalent outcomes for patients undergoing ABOi LDKT compared to ABO compatible (ABOc) LDKT, with similar graft-survival rates (7-9).…”

Section: Introductionmentioning

confidence: 99%

Landscape of ABO-Incompatible Live Donor Kidney Transplantation in the US

Mustian

Cannon

MacLennan

et al. 2018

Journal of the American College of Surgeons

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Clinical Outcomes and Results of Pathological Findings of 1-year Protocol Biopsy in Recipients of ABO-Incompatible Living Donor Kidney Transplantants

Cited by 7 publications

References 8 publications

Effects of Treating Subclinical Rejection 2 Weeks after Kidney Transplantation, as Determined by Analyzing 1-Year Histologic Outcomes

Effects of Treating Subclinical Rejection 2 Weeks after Kidney Transplantation, as Determined by Analyzing 1-Year Histologic Outcomes

Patient and Graft Survival After A1/A2-incompatible Living Donor Kidney Transplantation

Landscape of ABO-Incompatible Live Donor Kidney Transplantation in the US

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