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dc.contributor.authorCohney, Solomon (Shlomo)-
dc.contributor.otherFerrari, P.-
dc.contributor.otherHughes, Peter-
dc.contributor.otherWoodroffe, C.-
dc.contributor.otherFidler, S.-
dc.contributor.otherD'Orsogna, L.-
dc.identifier.citationTransplantation. 2013 Nov 15;96(9):821-6en_US
dc.description.abstractBACKGROUND: Although preformed donor-specific anti-human leukocyte antigen antibodies (DSA) can be overcome by plasmapheresis-based strategies with some success in renal transplantation, kidney paired donation (KPD) is a more effective strategy to avoid DSA. In contrast, ABO incompatibility can be crossed with outcomes equivalent to ABO-compatible transplantation. Here, we report the ability of accepting human leukocyte antigen-compatible but ABO-incompatible donors to increase the number of exchanges in a KPD program. METHODS: In the Australian KPD program, virtual crossmatch is used to allocate suitable donors to recipients. Acceptance of ABO-incompatible donors is allowed in cases where anti-blood group antibody titres are deemed amenable to removal by apheresis or immunoabsorption. The number of matched recipients, identified chains, and transplants performed with and without acceptance of ABO incompatibility was analyzed. RESULTS: In 2 years, 115 pairs were included in nine quarterly match runs. Incompatibility due to DSA accounted for 86% of the listed pairs and 52% were also blood group incompatible to their coregistered donor. Median calculated panel-reactive antibody in registered recipients was 83% (mean, 67%±37%). ABO-incompatible donors were accepted for 36 patients. Two waitlist recipients and 48 KPD candidates were matched and transplanted. Ten recipients (20%) of an ABO-incompatible donor kidney were distributed across 8 chains that resulted in 21 recipients being transplanted. Thus, without ABO-incompatible matching, only 27 recipients in 12 chains would have been transplanted. CONCLUSION: Acceptance of blood group-incompatible donors for patients with low to moderate anti-blood group antibody significantly increases transplant rates for highly sensitized recipients.en_US
dc.publisherWolters Kluweren_US
dc.subjectABO Blood-Group Systemen_US
dc.subjectBlood Group Incompatibilityen_US
dc.subjectBlood Grouping and Crossmatchingen_US
dc.subjectComputer Simulationen_US
dc.subjectDonor Selectionen_US
dc.subjectHLA Antigensen_US
dc.subjectKidney Transplantationen_US
dc.subjectTissue Donorsen_US
dc.subjectTreatment Outcomeen_US
dc.subjectDonor Specific Anti-Human Leukocyte Antigen Antibodiesen_US
dc.subjectPlasmapheresis-Based Strategiesen_US
dc.subjectKidney Paired Donationen_US
dc.subjectUroRenal, Vascular Clinical Institute, Epworth HealthCare, Victoria, Australiaen_US
dc.subjectDepartment of Nephrology, Epworth HealthCare, Richmond, Victoria, Australia.en_US
dc.titleABO-incompatible matching significantly enhances transplant rates in kidney paired donation.en_US
dc.typeJournal Articleen_US
dc.description.affiliatesDepartment of Nephrology, Fremantle Hospital, Perth, Western Australia, Australiaen_US
dc.description.affiliatesSchool of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australiaen_US
dc.description.affiliatesDepartment of Nephrology, Royal Melbourne Hospital, Parkville, Victoria, Australiaen_US
dc.description.affiliatesDepartment of Nephrology, Western Hospital, Footscray, Victoria, Australiaen_US
dc.description.affiliatesUniversity of Melbourne, Melbourne, Victoria, Australiaen_US
dc.description.affiliatesDepartment of Immunology, PathWest, Royal Perth Hospital, Perth, Western Australia, Australiaen_US
dc.description.affiliatesSchool of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australiaen_US
dc.type.studyortrialPredictive Value of Testsen_US
Appears in Collections:UroRenal, Vascular

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