Underutilization of A2 ABO incompatible kidney transplantation

Robert R. Redfield, Ronald F. Parsons, Eduardo Rodriguez, Moiz Mustafa, James Cassuto, Kumar Vivek, Hooman Noorchashm, Ali Naji, Matthew H. Levine, Peter L. Abt

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)489-494
Number of pages6
JournalClinical Transplantation
Issue number3
StatePublished - May 2012
Externally publishedYes


  • A2 blood group kidney
  • ABO incompatible transplantation
  • Kidney transplantation
  • Long-term graft outcomes
  • Waiting time

ASJC Scopus subject areas

  • Transplantation


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