TY - JOUR
T1 - Underutilization of A2 ABO incompatible kidney transplantation
AU - Redfield, Robert R.
AU - Parsons, Ronald F.
AU - Rodriguez, Eduardo
AU - Mustafa, Moiz
AU - Cassuto, James
AU - Vivek, Kumar
AU - Noorchashm, Hooman
AU - Naji, Ali
AU - Levine, Matthew H.
AU - Abt, Peter L.
PY - 2012/5
Y1 - 2012/5
N2 - Background: ABO compatibility creates a disadvantage for O and B renal allograft candidates. A2 ABO incompatible transplant may decrease waiting times and generate equivalent graft survival to an ABO compatible transplant. Methods: Death-censored graft survival was compared between A recipients and O, B, and AB recipients of an A2 allograft with multivariate Cox regression models utilizing data from the United Network of Organ Sharing (UNOS) between 1997 and 2007. Results: Eighty-five percent of A2 kidneys were transplanted into ABO compatible recipients vs. 15% into ABO incompatible recipients. Rates of A2 incompatible kidney transplants did not increase over the study period (14.8% to 14.6%). Mean wait time for A2→O kidneys was 337 vs. 684d for O→O and for A2→B kidneys, 542 vs. 734d for B→B. Adjusted relative risk of graft loss at five-yr was similar between O, B, and AB recipients compared to A recipients of an A2 allograft, corresponding to a five-yr graft survival of 84%, 86.2%, 86.1%, and 86.1%, respectively. Conclusion: A2 incompatible kidney transplantation is underutilized. Graft outcomes are similar among A2 compatible and incompatible recipients. Shorter waiting time and improved access might be achieved if A2 kidneys are considered in all blood groups.
AB - Background: ABO compatibility creates a disadvantage for O and B renal allograft candidates. A2 ABO incompatible transplant may decrease waiting times and generate equivalent graft survival to an ABO compatible transplant. Methods: Death-censored graft survival was compared between A recipients and O, B, and AB recipients of an A2 allograft with multivariate Cox regression models utilizing data from the United Network of Organ Sharing (UNOS) between 1997 and 2007. Results: Eighty-five percent of A2 kidneys were transplanted into ABO compatible recipients vs. 15% into ABO incompatible recipients. Rates of A2 incompatible kidney transplants did not increase over the study period (14.8% to 14.6%). Mean wait time for A2→O kidneys was 337 vs. 684d for O→O and for A2→B kidneys, 542 vs. 734d for B→B. Adjusted relative risk of graft loss at five-yr was similar between O, B, and AB recipients compared to A recipients of an A2 allograft, corresponding to a five-yr graft survival of 84%, 86.2%, 86.1%, and 86.1%, respectively. Conclusion: A2 incompatible kidney transplantation is underutilized. Graft outcomes are similar among A2 compatible and incompatible recipients. Shorter waiting time and improved access might be achieved if A2 kidneys are considered in all blood groups.
KW - A2 blood group kidney
KW - ABO incompatible transplantation
KW - Kidney transplantation
KW - Long-term graft outcomes
KW - Waiting time
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U2 - 10.1111/j.1399-0012.2011.01543.x
DO - 10.1111/j.1399-0012.2011.01543.x
M3 - Article
C2 - 22032287
AN - SCOPUS:84862240303
SN - 0902-0063
VL - 26
SP - 489
EP - 494
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 3
ER -