Outcome of ABO Blood Type–Incompatible Living-Related Donor Kidney Transplantation Under a Contemporary Immunosuppression Strategy in Japan

Hamano, Itsuto; Hatakeyama, Shingo; Fujita, Takeshi; Murakami, Reiichi; Hamaya, Tomoko; Togashi, Kyo; Suzuki, Yuichiro; Yamamoto, Hayato; Yoneyama, T.; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Narumi, Shunji; Tomita, Hirofumi; Οhyama, Chikara

doi:10.1016/j.transproceed.2020.01.152

Cited by 9 publications

(8 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The European Collaborative Transplant Study (CTS) (21), one of the largest registry to date, analyzing outcomes of 1,420 AB0i recipients and matched AB0c controls, reported identical death-censored graft survival in the two groups at 3 years, as in our study. Other studies from different Countries confirmed the same results (12,22,23). The U.S. Scientific Registry of Transplant Recipients, with 738 AB0i LDKTs and matched controls, recorded a statistically significant lower graft survival in AB0i recipients, mainly driven by graft loss in the first two weeks after transplantation, while, after 14 days from surgery, graft survival became similar to that of AB0c controls on a long-term follow up (24).…”

Section: Discussionsupporting

confidence: 53%

Outcomes in AB0 Incompatible Living Donor Kidney Transplantation: A Case – Control Study

Cozzi

Donato²,

Ugolini³

et al. 2022

Front. Med.

View full text Add to dashboard Cite

BackgroundPatients waiting for a kidney transplant by far exceed available organs. AB0 incompatible living donor kidney transplantation (AB0i LDKT) represents an additional therapeutic strategy, but with higher risk for complications. We aimed at evaluating outcomes of AB0i LDKTs compared to compatible (AB0c) controls at our Institution.MethodsRetrospective matched case – control study (1:2) comparing AB0i vs. AB0c LDKTs from March 2012 to September 2021. Considered outcomes: graft function, acute rejection, sepsis, CMV infection, BK virus reactivation, death-censored graft survival, patient survival.ResultsSeventeen AB0i LDKTs matched to 34 AB0c controls. We found excellent graft function, comparable in the two groups, at all considered intervals, with an eGFR (ml/min/1.73 m2) of 67 vs. 66 at 1 year (p = 0.41), 63 vs. 64 at 3 years (p = 0.53). AB0i recipients had a statistically significant higher incidence of acute rejection, acute antibody-mediated rejection and sepsis within 30 days (p = 0.016; p = 0.02; p = 0.001), 1 year (p = 0.012; p = 0.02; p = 0.0004) and 3 years (p = 0.004; p = 0.006; p = 0.012) after surgery. There was no difference in CMV infection, BK virus reactivation, death-censored graft survival between the two groups. Patient survival was inferior in AB0i group at 1 and 3 years (88.2 vs. 100%; log-rank p = 0.03) due to early death for opportunistic infections. AB0i LDKTs spent longer time on dialysis (p = 0.04) and 82.3 vs. 38.3% controls had blood group 0 (p = 0.003).ConclusionsAB0i LDKT is an effective therapeutic strategy with graft function and survival comparable to AB0c LDKTs, despite higher rates of acute rejection and sepsis. It is an additional opportunity for patients with less chances of being transplanted, as blood group 0 individuals.

show abstract

Section: Discussionsupporting

confidence: 53%

Outcomes in AB0 Incompatible Living Donor Kidney Transplantation: A Case – Control Study

Cozzi

Donato²,

Ugolini³

et al. 2022

Front. Med.

View full text Add to dashboard Cite

show abstract

“…As KT protocols vary across countries and regions, the vaccine efficacy has not been fully validated in KT recipients in Japan. In Japan, ABO blood-type incompatible (ABOi) KT protocols with strong immunosuppression strategies are necessary due to the absence of donor exchange programs and the serious donor shortage 9 – 13 . Currently, one-third of the recipients undergo ABOi KT with rituximab desensitization.…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2 spike IgG antibodies after the second BNT162b2 mRNA vaccine in Japanese kidney transplant recipients

Hamaya

Yoneyama

Tobisawa

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

We aimed to evaluate the seroprevalence and investigated factors associated with seropositivity after the second SARS-CoV-2 mRNA vaccination in kidney transplant (KT) recipients. This retrospective study conducted between June and November 2021 included 106 KT recipients and 127 healthy controls who received the second dose of the BNT162b2 mRNA vaccine at least 7 days before the measurement of antibody titers. The antibody titer against the receptor-binding domain of SARS-CoV-2 spike (S) protein was determined. We compared seroprevalence rates (immunoglobulin G [IgG] level of ≥ 0.8 or ≥ 15 U/mL) between the healthy controls and KT recipients and identified factors associated with impaired humoral response. The seroprevalence rate of the healthy controls and KT recipients was 98% and 22%, respectively. Univariate logistic regression analysis revealed that age > 53 years, rituximab use, mycophenolate mofetil use, and KT vintage < 7 years were negatively associated with the rate of anti-SARS-CoV-2 S IgG ≥ 15 U/mL in KT recipients. ABO blood type incompatible KT was not significantly associated with seroprevalence. Humoral response after the second BNT162b2 mRNA vaccine was greatly hindered by immunosuppression therapy in KT recipients. Older age, rituximab use, mycophenolate mofetil use, and KT vintage may play key roles in seroconversion.

show abstract

“…Although some studies reported an increased susceptibility to infections in patients undergoing ABOi-KT compared with ABOc-KT, [5][6][7][8][9] other studies did not support these findings. [10][11][12] Therefore, uncertainty about safety of ABOi-KT with regard to infectious complications still remains and may affect its implementation by transplant centers.…”

Section: Introductionmentioning

confidence: 99%

Infection Risk in the First Year After ABO-incompatible Kidney Transplantation: A Nationwide Prospective Cohort Study

et al. 2022

View full text Add to dashboard Cite

Background. ABO-incompatible (ABOi) kidney transplantation (KT) expands the kidney donor pool and may help to overcome organ shortage. Nonetheless, concerns about infectious complications associated with ABOi-KT have been raised. Methods. In a nationwide cohort (Swiss Transplant Cohort Study), we compared the risk for infectious complications among ABOi and ABO-compatible (ABOc) renal transplant recipients. Infections needed to fulfill rigorous, prespecified criteria to be classified as clinically relevant. Unadjusted and adjusted competing risk regression models were used to compare the time to the first clinically relevant infection among ABOi-KT and ABOc-KT recipients. Inverse probability weighted generalized mixedeffects Poisson regression was used to estimate incidence rate ratios for infection. Results. We included 757 living-donor KT recipients (639 ABOc; 118 ABOi) and identified 717 infection episodes. The spectrum of causative pathogens and the anatomical sites affected by infections were similar between ABOi-KT and ABOc-KT recipients. There was no significant difference in time to first posttransplant infection between ABOi-KT and ABOc-KT recipients (subhazard ratio, 1.24; 95% confidence interval [CI], 0.93-1.66; P = 0.142). At 1 y, the crude infection rate was 1.11 (95% CI, 0.93-1.33) episodes per patient-year for ABOi patients and 0.94 (95% CI, 0.86-1.01) for ABOc-KT recipients. Inverse probability weighted infection rates were similar between groups (adjusted incidence rate ratio, 1.12; 95% CI, 0.83-1.52; P = 0.461). Conclusions. The burden of infections during the first year posttransplant was high but not relevantly different in ABOi-KT and ABOc-KT recipients. Our results highlight that concerns regarding infectious complications should not affect the implementation of ABOi-KT programs.

show abstract

Outcome of ABO Blood Type–Incompatible Living-Related Donor Kidney Transplantation Under a Contemporary Immunosuppression Strategy in Japan

Cited by 9 publications

References 22 publications

Outcomes in AB0 Incompatible Living Donor Kidney Transplantation: A Case – Control Study

Outcomes in AB0 Incompatible Living Donor Kidney Transplantation: A Case – Control Study

Seroprevalence of SARS-CoV-2 spike IgG antibodies after the second BNT162b2 mRNA vaccine in Japanese kidney transplant recipients

Infection Risk in the First Year After ABO-incompatible Kidney Transplantation: A Nationwide Prospective Cohort Study

Contact Info

Product

Resources

About