AUTHOR=Eskandary Farsad , Böhmig Georg A. 

TITLE=ABO-Incompatibility: Time to Challenge the Paradigm of Equivalence in Live-Donor Kidney Transplantation?

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10281

DOI=10.3389/ti.2022.10281

ISSN=1432-2277

ABSTRACT=ABO blood group-incompatible live-donor kidney transplantation (ABOi-LDKT) has evolved to a standard procedure in many European centres nowadays. However, the frequently reported equivalence of outcomes with respect to ABO blood group-compatible live-donor kidney transplantation (ABOc-LDKT) has more and more become a matter of debate. De Weerd et al. conducted a retrospective multicentric cohort study in the Netherlands and, by applying propensity matching, found that ABOi-LDKT seems to be equivalent to ABOc-LDKT when looking at patient survival, but with respect to death-censored graft survival, ABOc-LDKT shows better outcomes. In sub-analyses, the type of induction regimen also shows differences in rejection rates, patient- and graft survival, with rituximab mono-induction being inferior to rituximab/basiliximab or alemtuzumab, respectively. Importantly the authors also compared ABOi-LDKT with ABO blood group-compatible deceased-donor transplants (ABOc-DD), where ABOi-LDKT shows a clear benefit. Taken together, this study adds important information to the field of ABOi-LDKT and may help to alternatively consider referral of ABOi donor/recipient pairs to kidney-paired donation programs after careful consideration and counseling by their treating transplant physicians.