대한신장학회

논문분류	춘계학술대회 초록집
제목	Spousal Donor ABO Incompatible Kidney Transplantations are not Inferior to Spousal Donor ABO Compatible Kidney Transplantations
저자	Jihyun Yu, Byung Ha Chung, Bum Soon Choi, Chul Woo Yang, Curie Ahn, Jong Cheol Jeong, Jaeseok Yang, Myung Gyu Kim, Yu Seun Kim, Myung Soo Kim, Oh Jung Kwon, Sung-Joo Kim, Yeong Hoon Kim, SooJinNa Choi, WonHyun Cho
출판정보	2015; 2015(1):
키워드	ABO-incompatibility, Spousal donor, Kidney transplantation
초록	Background: Due to donor organ shortage and advancement of transplantation medicine, proportions of kidney transplantation (KT) from spousal donor (SD) and/or ABO incompatible (ABOi) donor are increasing. But the outcomes of combination of SD with ABOi KT are not well known. The aim of this study was to show the non-inferiority of the SD grafts outcomes in ABOi KT to those of ABO compatible (ABOc) KT. Method: From 3043 living donor KTs performed at 57 kidney transplantation centers registered in the Korean Organ Transplantation Registry, ABOi and ABOc SD KT groups were analyzed before and after 1 to 2 propensity score matching. Highly sensitized patients (defined as % panel reactive antibody over 80%) were excluded in this study. The primary outcomes were survival rates for grafts and patients. The secondary outcomes were biopsy proven acute rejection (BPAR)-free survival rate and renal function between the two groups. We also analyzed risk factors affecting the primary and secondary outcomes. Result: There was no difference between ABOi SD KT group (n=125) and ABOc SD KT group (n=445) in baseline clinical characteristics and immunosuppressive regimen except a proportion of taking cyclosporine (4.8% vs. 17.8%, p=0.002). The 3-year death censored graft survival and patient survival for ABOi SD KT were similar to ABOc SD KT (92.9% vs. 95.9%, P=0.506, for graft survival; 96.8% vs. 98.6%, P=0.139, for patient survival). The 3-year biopsy proven acute rejection (BPAR) -free survival rates were also comparable between the two groups (78.1% vs. 83.1%, p=0.141). The renal allograft function showed no difference at 6 and 12 months after KT between the two groups. After 1 to 2 propensity score matching, there was no difference in primary and secondary outcomes between two groups, as well. Conclusion: The outcomes of SD graft in ABOi KT are not inferior to those of ABOc KT in short term. ABO incompatibility did not affect the graft, patient survival and BPAR-free survival rate in SD KT. The low risk SD ABO incompatible KT can be a good alternative in recent era of donor organ shortage.
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