ABO-incompatible kidney transplantation in perspective of deceased donor transplantation and induction strategies: a propensity-matched analysis

A.E. de Weerd; J.A.J.G. van den Brand; H. Bouwsma; A.P.J. de Vries; I.M.M. Dooper; J.S.F. Sanders; M.H.L. Christiaans; F.E. van Reekum; A.D. van Zuilen; F.J. Bemelman; A.S. Nurmohamed; M. van Agteren; M.G.H. Betjes; M.F.C. de Jong; M.C. Baas

doi:10.1111/tri.14145

ABO-incompatible kidney transplantation in perspective of deceased donor transplantation and induction strategies: a propensity-matched analysis

A.E. de Weerd^*, J.A.J.G. van den Brand, H. Bouwsma, A.P.J. de Vries, I.M.M. Dooper, J.S.F. Sanders, M.H.L. Christiaans, F.E. van Reekum, A.D. van Zuilen, F.J. Bemelman, A.S. Nurmohamed, M. van Agteren, M.G.H. Betjes, M.F.C. de Jong, M.C. Baas

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Kidney transplant candidates are blood group incompatible with roughly one out of three potential living donors. We compared outcomes after ABO-incompatible (ABOi) kidney transplantation with matched ABO-compatible (ABOc) living and deceased donor transplantation and analyzed different induction regimens. We performed a retrospective study with propensity matching and compared patient and death-censored graft survival after ABOi versus ABOc living donor and deceased donor kidney transplantation in a nationwide registry from 2006 till 2019. 296 ABOi were compared with 1184 center and propensity-matched ABOc living donor and 1184 deceased donor recipients (matching: recipient age, sex, blood group, and PRA). Patient survival was better compared with deceased donor [hazard ratio (HR) for death of HR 0.69 (0.49-0.96)] and non-significantly different from ABOc living donor recipients [HR 1.28 (0.90-1.81)]. Rate of graft failure was higher compared with ABOc living donor transplantation [HR 2.63 (1.72-4.01)]. Rejection occurred in 47% of 140 rituximab versus 22% of 50 rituximab/basiliximab, and 4% of 92 alemtuzumab-treated recipients (P < 0.001). ABOi kidney transplantation is superior to deceased donor transplantation. Rejection rate and graft failure are higher compared with matched ABOc living donor transplantation, underscoring the need for further studies into risk stratification and induction therapy [NTR7587, ].

Original language	English
Pages (from-to)	2706-2719
Number of pages	14
Journal	Transplant International
Volume	34
Issue number	12
Early online date	11 Nov 2021
DOIs	https://doi.org/10.1111/tri.14145
Publication status	Published - Dec 2021

Keywords

ABO-incompatible kidney transplantation
alemtuzumab
deceased donor transplantation
living donor transplantation
patient and graft survival
rejection
ANTIGEN-SPECIFIC IMMUNOADSORPTION
HIGHLY SENSITIZED PATIENTS
RENAL-TRANSPLANTATION
RITUXIMAB
SURVIVAL
OUTCOMES
BARRIER

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Cite this

de Weerd, A. E., van den Brand, J. A. J. G., Bouwsma, H., de Vries, A. P. J., Dooper, I. M. M., Sanders, J. S. F., Christiaans, M. H. L., van Reekum, F. E., van Zuilen, A. D., Bemelman, F. J., Nurmohamed, A. S., van Agteren, M., Betjes, M. G. H., de Jong, M. F. C., & Baas, M. C. (2021). ABO-incompatible kidney transplantation in perspective of deceased donor transplantation and induction strategies: a propensity-matched analysis. Transplant International, 34(12), 2706-2719. https://doi.org/10.1111/tri.14145

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title = "ABO-incompatible kidney transplantation in perspective of deceased donor transplantation and induction strategies: a propensity-matched analysis",

abstract = "Kidney transplant candidates are blood group incompatible with roughly one out of three potential living donors. We compared outcomes after ABO-incompatible (ABOi) kidney transplantation with matched ABO-compatible (ABOc) living and deceased donor transplantation and analyzed different induction regimens. We performed a retrospective study with propensity matching and compared patient and death-censored graft survival after ABOi versus ABOc living donor and deceased donor kidney transplantation in a nationwide registry from 2006 till 2019. 296 ABOi were compared with 1184 center and propensity-matched ABOc living donor and 1184 deceased donor recipients (matching: recipient age, sex, blood group, and PRA). Patient survival was better compared with deceased donor [hazard ratio (HR) for death of HR 0.69 (0.49-0.96)] and non-significantly different from ABOc living donor recipients [HR 1.28 (0.90-1.81)]. Rate of graft failure was higher compared with ABOc living donor transplantation [HR 2.63 (1.72-4.01)]. Rejection occurred in 47% of 140 rituximab versus 22% of 50 rituximab/basiliximab, and 4% of 92 alemtuzumab-treated recipients (P < 0.001). ABOi kidney transplantation is superior to deceased donor transplantation. Rejection rate and graft failure are higher compared with matched ABOc living donor transplantation, underscoring the need for further studies into risk stratification and induction therapy [NTR7587, ].",

keywords = "ABO-incompatible kidney transplantation, alemtuzumab, deceased donor transplantation, living donor transplantation, patient and graft survival, rejection, ANTIGEN-SPECIFIC IMMUNOADSORPTION, HIGHLY SENSITIZED PATIENTS, RENAL-TRANSPLANTATION, RITUXIMAB, SURVIVAL, OUTCOMES, BARRIER",

author = "{de Weerd}, A.E. and {van den Brand}, J.A.J.G. and H. Bouwsma and {de Vries}, A.P.J. and I.M.M. Dooper and J.S.F. Sanders and M.H.L. Christiaans and {van Reekum}, F.E. and {van Zuilen}, A.D. and F.J. Bemelman and A.S. Nurmohamed and {van Agteren}, M. and M.G.H. Betjes and {de Jong}, M.F.C. and M.C. Baas",

year = "2021",

month = dec,

doi = "10.1111/tri.14145",

language = "English",

volume = "34",

pages = "2706--2719",

journal = "Transplant International",

issn = "0934-0874",

publisher = "Wiley",

number = "12",

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de Weerd, AE, van den Brand, JAJG, Bouwsma, H, de Vries, APJ, Dooper, IMM, Sanders, JSF, Christiaans, MHL, van Reekum, FE, van Zuilen, AD, Bemelman, FJ, Nurmohamed, AS, van Agteren, M, Betjes, MGH, de Jong, MFC & Baas, MC 2021, 'ABO-incompatible kidney transplantation in perspective of deceased donor transplantation and induction strategies: a propensity-matched analysis', Transplant International, vol. 34, no. 12, pp. 2706-2719. https://doi.org/10.1111/tri.14145

TY - JOUR

T1 - ABO-incompatible kidney transplantation in perspective of deceased donor transplantation and induction strategies: a propensity-matched analysis

AU - de Weerd, A.E.

AU - van den Brand, J.A.J.G.

AU - Bouwsma, H.

AU - de Vries, A.P.J.

AU - Dooper, I.M.M.

AU - Sanders, J.S.F.

AU - Christiaans, M.H.L.

AU - van Reekum, F.E.

AU - van Zuilen, A.D.

AU - Bemelman, F.J.

AU - Nurmohamed, A.S.

AU - van Agteren, M.

AU - Betjes, M.G.H.

AU - de Jong, M.F.C.

AU - Baas, M.C.

PY - 2021/12

Y1 - 2021/12

N2 - Kidney transplant candidates are blood group incompatible with roughly one out of three potential living donors. We compared outcomes after ABO-incompatible (ABOi) kidney transplantation with matched ABO-compatible (ABOc) living and deceased donor transplantation and analyzed different induction regimens. We performed a retrospective study with propensity matching and compared patient and death-censored graft survival after ABOi versus ABOc living donor and deceased donor kidney transplantation in a nationwide registry from 2006 till 2019. 296 ABOi were compared with 1184 center and propensity-matched ABOc living donor and 1184 deceased donor recipients (matching: recipient age, sex, blood group, and PRA). Patient survival was better compared with deceased donor [hazard ratio (HR) for death of HR 0.69 (0.49-0.96)] and non-significantly different from ABOc living donor recipients [HR 1.28 (0.90-1.81)]. Rate of graft failure was higher compared with ABOc living donor transplantation [HR 2.63 (1.72-4.01)]. Rejection occurred in 47% of 140 rituximab versus 22% of 50 rituximab/basiliximab, and 4% of 92 alemtuzumab-treated recipients (P < 0.001). ABOi kidney transplantation is superior to deceased donor transplantation. Rejection rate and graft failure are higher compared with matched ABOc living donor transplantation, underscoring the need for further studies into risk stratification and induction therapy [NTR7587, ].

AB - Kidney transplant candidates are blood group incompatible with roughly one out of three potential living donors. We compared outcomes after ABO-incompatible (ABOi) kidney transplantation with matched ABO-compatible (ABOc) living and deceased donor transplantation and analyzed different induction regimens. We performed a retrospective study with propensity matching and compared patient and death-censored graft survival after ABOi versus ABOc living donor and deceased donor kidney transplantation in a nationwide registry from 2006 till 2019. 296 ABOi were compared with 1184 center and propensity-matched ABOc living donor and 1184 deceased donor recipients (matching: recipient age, sex, blood group, and PRA). Patient survival was better compared with deceased donor [hazard ratio (HR) for death of HR 0.69 (0.49-0.96)] and non-significantly different from ABOc living donor recipients [HR 1.28 (0.90-1.81)]. Rate of graft failure was higher compared with ABOc living donor transplantation [HR 2.63 (1.72-4.01)]. Rejection occurred in 47% of 140 rituximab versus 22% of 50 rituximab/basiliximab, and 4% of 92 alemtuzumab-treated recipients (P < 0.001). ABOi kidney transplantation is superior to deceased donor transplantation. Rejection rate and graft failure are higher compared with matched ABOc living donor transplantation, underscoring the need for further studies into risk stratification and induction therapy [NTR7587, ].

KW - ABO-incompatible kidney transplantation

KW - alemtuzumab

KW - deceased donor transplantation

KW - living donor transplantation

KW - patient and graft survival

KW - rejection

KW - ANTIGEN-SPECIFIC IMMUNOADSORPTION

KW - HIGHLY SENSITIZED PATIENTS

KW - RENAL-TRANSPLANTATION

KW - RITUXIMAB

KW - SURVIVAL

KW - OUTCOMES

KW - BARRIER

U2 - 10.1111/tri.14145

DO - 10.1111/tri.14145

M3 - Article

C2 - 34687095

SN - 0934-0874

VL - 34

SP - 2706

EP - 2719

JO - Transplant International

JF - Transplant International

IS - 12

ER -