ABO-Incompatible Renal Transplant: A Single-Center Experience from India.
In: Indian Journal of Nephrology, Jg. 34 (2024), Heft 1, S. 24-30
Online
academicJournal
Zugriff:
Introduction: In view of ever-increasing end-stage renal disease (ESRD) population but inadequate availability of suitable donors, ABO-incompatible (ABOi) transplantation can be an important void filler. However, at present, ABOi transplantation is limited to a few centers in India and there is a lack of adequate experience and expertise to guide this program to other centers in the country. Methods: Data of all the ABOi transplants performed from 2012 to 2021 in a tertiary care hospital was retrospectively analyzed. The anti-ABO antibody (IgG) titers (≤1:4) were considered safe before transplantation. Desensitization included rituximab, plasma exchange, or selective immunoadsorption column. Tacrolimus and mycophenolate mofetil were initiated at day -7. Induction agents included ATG, ATLG, basiliximab, or no induction. Postoperatively, anti-ABO titers were done daily for 2 weeks. Results: A total of 202 patients underwent transplantation; of these, 195 patients whose data were for available for 12 months were included in the study. Mean duration of follow-up was 28.9 ± 21.7 months. UTI was the most common source of infection, occurring in almost half (46.1%) of the patients. Antibody-mediated rejection (ABMR; 15%) was common in the first year. Patient survival was 86.6% (169/195) at 1 year. Sepsis was the most common of death in more than two-thirds of the population, including coronavirus disease 2019 (COVID-19)-associated mortality in nine patients (4.6%). Death-censored graft survival was 89.3% (174/195). AMR was the leading cause of graft loss in almost half of the patients. Conclusion: ABOi should be considered in ESRD patients for whom suitable ABO-compatible donor is not available. Higher rate of rejection and infection are still a major concern. [ABSTRACT FROM AUTHOR]
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ABO-Incompatible Renal Transplant: A Single-Center Experience from India.
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Autor/in / Beteiligte Person: | Pawar, Nikita ; Tiwari, Vaibhav ; Gupta, Anurag ; Divyaveer, Smita ; Rather, Imran ; Chadha, Shiv ; Bhargava, Vinant ; Malik, Manish ; Gupta, Ashwani ; Bhalla, Anil Kumar ; Rana, D. S. ; Gupta, Pallav |
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Zeitschrift: | Indian Journal of Nephrology, Jg. 34 (2024), Heft 1, S. 24-30 |
Veröffentlichung: | 2024 |
Medientyp: | academicJournal |
ISSN: | 0971-4065 (print) |
DOI: | 10.4103/ijn.ijn_247_22 |
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