Jha Pranaw Kumar, Bansal Shyam Bihari, Rana Abhyudaysingh, Nandwani Ashish, Kher Ajay, Sethi Sidharth, Jain Manish, Bansal Dinesh, Yadav Dinesh Kumar, Gadde Ashwini, Mahapatra Amit Kumar, Sodhi Puneet, Ahlawat Rajesh, Kher Vijay
Department of Nephrology, Medanta - The Medicity, Sector 38, Gurugram, Haryana, India.
Department of Nephrology, Max Super Specialty Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India.
Indian J Nephrol. 2022 Jan-Feb;32(1):42-46. doi: 10.4103/ijn.IJN_465_20. Epub 2021 Sep 21.
ABO-incompatible (ABOi) kidney transplantation overcomes immunological barrier of blood group incompatibility. There have been very few published experiences of ABOi kidney transplantation from India. We present our single-center experience of the first hundred ABOi kidney transplants.
This is a single-center retrospective study of consecutive first hundred ABOi kidney transplant with at least 6 months of follow-up.
During the study period (2011-2020), a total of 121 ABOi kidney transplants were performed. Of these, first hundred patients were analyzed. Median follow-up duration was 33 (10-101) months. Mean recipient and donor age were 41.5 ± 13 and 47.68 ± 11.25 years, respectively. Mean HLA mismatch was 4 ± 1.5. Median baseline anti-blood group antibody titer was 128 (2-1024). Most common recipient blood group was O. Patient and death censored graft survival was 93% and 94%, respectively, at median follow-up of 33 months. Biopsy-proven acute rejection (BPAR) rate was 17% with acute antibody-mediated rejection being 3%. Rate of infection was 37%, most common being urinary tract infection.
ABOi kidney transplant patients had acceptable patient and graft survival as well as BPAR rates. With current preconditioning protocol, infection rate was high.
ABO血型不相容（ABOi）肾移植克服了血型不相容的免疫屏障。印度关于ABOi肾移植的已发表经验非常少。我们展示了我们单中心首例100例ABOi肾移植的经验。
这是一项单中心回顾性研究，纳入连续的首例100例ABOi肾移植患者，随访至少6个月。
在研究期间（2011 - 2020年），共进行了121例ABOi肾移植。其中，对首例100例患者进行了分析。中位随访时间为33（10 - 101）个月。受者和供者的平均年龄分别为41.5±13岁和47.68±11.25岁。平均HLA错配数为4±1.5。基线抗血型抗体滴度中位数为128（2 - 1024）。最常见的受者血型为O型。在33个月的中位随访时，患者及死亡截尾移植肾存活率分别为93%和94%。活检证实的急性排斥反应（BPAR）率为17%，急性抗体介导的排斥反应为3%。感染率为37%，最常见的是尿路感染。
ABOi肾移植患者的患者及移植肾存活率以及BPAR率是可接受的。采用当前的预处理方案，感染率较高。
