Outcomes of ABO‐incompatible kidney transplantation in older patients: a national cohort study.

Kim, Deok Gie; Lee, Juhan; Kim, Myoung Soo; Kwon, Oh Jung; Jung, Cheol Woong; Lee, Kang Wook; Yang, Jaeseok; Ahn, Curie; Huh, Kyu Ha

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.

OLDER patients; KIDNEY transplantation; KIDNEY exchange; BLOOD group incompatibility; COHORT analysis; TRANSPLANTATION of organs, tissues, etc.; TREATMENT effectiveness

Transplant International, 2021, Vol 34, Issue 2, p290

0934-0874

Academic Journal

10.1111/tri.13794