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논문분류	춘계학술대회 초록집
제목	Graft Outcomes of ABOi-KTs Are Superior to Those of ABOc-KTs Over a Follow-up of 15 Years: Single Center Experiences
저자	Dong Ryeol Lee
출판정보	2025; 2025(1):
키워드	ABO incompatible , kidney transplantation, gaft outcome
초록	Donor-specific anti-HLA antibody (DSA) and Anti-ABO antibodies are major barriers to successful kidney transplantation. Current desensitization treatments showed that outcomes of ABOi-KTs were inferior to or comparable to ABOc-KTs. Our center was the first hospital to successfully perform the ABO-i KTs in Korea on February 15, 2007. We examined 282 stable KTRs (200 ABOc-KTs and 82 ABOi-KTs) from February 2000 to June 2024. Fifty-two recipients were biopsied (37 in ABOc-KTs and 15 in ABOi-KTs) with DSAs on a single antigen bead assay. Our study compares the graft and clinical outcomes between ABOi-KTs and ABO-c KTs over a 15-year follow-up period. Recipients and donors of ABOi-KTs were generally older than those of ABO-c KTs (47.8 ± 10.2 vs. 43.0 ± 12.5 years, p=0.002 and 44.6 ± 12.3 vs. 40.0 ± 12.9 years, p=0.007, respectively. The number of HLA mismatches, the proportion of 2nd transplants (3.9 ± 1.1 vs. 3.1 ± 1.6, p=0.001 and 2.5% vs. 9.1%, p=0.05), and the percentage of high total HLA class II EP MM (50.0% vs. 69.2%, p=0.03) were significantly higher in ABOi-KTs than ABOc-KTs. Graft failure rates were significantly lower in ABOi-KTs than in ABOc-KTs (1.2% vs 10.0%, p=0.01), even though it was accompanied by a similar proportion of HLAi-KTs. The 15-year graft survival rate of ABOi-KTs was excellent and comparable to that of ABO-c KTs (97% vs. 96%, p=0.62). ABO-iKTs, despite older recipient and donor age, higher HLA mismatches / higher HLA class II EP MM, greater proportion of 2nd KTs and living unrelated donor, demonstrated lower graft failure rates and long-term graft survival comparable to or better than ABO-c KTs over a 15-year follow-up period. Our excellent graft outcomes highlight the potential of ABOi-KTs to expand the donor pool and improve transplant success rates with appropriate patient management and clinical protocols.
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