Helena Genberg
Karolinska University Hospital, Sweden
Title: ABO-Incompatible living donor kidney transplantation - The stockholm experience
Biography
Biography: Helena Genberg
Abstract
ABO-incompatible (ABOi) living donor (LD) kidney transplantation has gained widespread popularity over the past 15 years. Worldwide over 3000 ABOi LD kidney transplantations have been reported. In Stockholm a protocol for ABOi transplantation was introduced in 2001 based on antigen-specific immunoadsorption for the anti-A/B antibody removal and rituximab to prevent antibody rebound. Since then some 100 ABOi transplantations have been performed there. The results of these transplantations have been evaluated in several studies and shown to be comparable with ABO-compatible LD kidney transplantation short-term. Similar results have also been reported from other centers. However, there are reports of inferior graft survival long-term following ABOi LD kidney transplantation when compared with ABO-compatible (ABOc) LD kidney transplantation. Yet, for the ABOi LD kidney recipients an ABOc living donor is rarely available. The alternative to dialysis or ABOi transplantation, is instead to enter the waiting list to possibly receive a deceased donor ABOc organ. In a recent study we compared the long-term results of ABOi LD kidney transplantation with wait listing. In this study the 10-year patient survival was 93% for the ABOi kidney recipients, 86% for the ABOc LD kidney recipients and 74% for patients entering the waiting list, p (overall) = 0.000. In conclusion, we argue that, for patients in the need of a kidney transplant, ABOi LD kidney transplantation is safe and a superior alternative to deceased donor wait listing.