Abstract
PURPOSE OF REVIEW: Although ABO incompatible kidney transplantation is increasingly recognized as effective, the procedure is still evolving. The purpose of this review is to summarize recent advances in this area. RECENT FINDINGS: Short to intermediate-term outcome appears good, although long-term results are still preliminary. Pretransplant risk stratification based on antidonor antibody titer may be of limited value. Splenectomy, previously reported to be an important component of ABO incompatible transplantation, appears to be avoidable under many circumstances. The wider implementation of A2 blood group incompatible transplantation shortens waiting time for deceased donor transplantation of blood group B recipients without significantly disadvantaging others. The diagnosis of acute humoral rejection has become clearer following the recognition that C4d deposition commonly occurs in well functioning ABO incompatible allografts. The long-term implications of acute humoral rejection appear substantial even following successful acute therapy, with a significant percentage of patients developing chronic humoral rejection manifested as transplant glomerulopathy. Finally, although ABO incompatible transplantation entails increased expense, when compared with maintenance dialysis and taking into account the health related quality of life benefits of a successful transplant, it is clearly cost effective. SUMMARY: ABO incompatible kidney transplantation is an effective therapy, and will become more widely implemented in the future.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 529-534 |
| Number of pages | 6 |
| Journal | Current Opinion in Nephrology and Hypertension |
| Volume | 16 |
| Issue number | 6 |
| DOIs | |
| State | Published - Nov 2007 |
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Keywords
- ABO incompatible
- Kidney transplantation
ASJC Scopus subject areas
- Internal Medicine
- Nephrology
Cite this
ABO incompatible kidney transplantation. / Gloor, James M.; Stegall, Mark D.
In: Current Opinion in Nephrology and Hypertension, Vol. 16, No. 6, 11.2007, p. 529-534.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - ABO incompatible kidney transplantation
AU - Gloor, James M.
AU - Stegall, Mark D
PY - 2007/11
Y1 - 2007/11
N2 - PURPOSE OF REVIEW: Although ABO incompatible kidney transplantation is increasingly recognized as effective, the procedure is still evolving. The purpose of this review is to summarize recent advances in this area. RECENT FINDINGS: Short to intermediate-term outcome appears good, although long-term results are still preliminary. Pretransplant risk stratification based on antidonor antibody titer may be of limited value. Splenectomy, previously reported to be an important component of ABO incompatible transplantation, appears to be avoidable under many circumstances. The wider implementation of A2 blood group incompatible transplantation shortens waiting time for deceased donor transplantation of blood group B recipients without significantly disadvantaging others. The diagnosis of acute humoral rejection has become clearer following the recognition that C4d deposition commonly occurs in well functioning ABO incompatible allografts. The long-term implications of acute humoral rejection appear substantial even following successful acute therapy, with a significant percentage of patients developing chronic humoral rejection manifested as transplant glomerulopathy. Finally, although ABO incompatible transplantation entails increased expense, when compared with maintenance dialysis and taking into account the health related quality of life benefits of a successful transplant, it is clearly cost effective. SUMMARY: ABO incompatible kidney transplantation is an effective therapy, and will become more widely implemented in the future.
AB - PURPOSE OF REVIEW: Although ABO incompatible kidney transplantation is increasingly recognized as effective, the procedure is still evolving. The purpose of this review is to summarize recent advances in this area. RECENT FINDINGS: Short to intermediate-term outcome appears good, although long-term results are still preliminary. Pretransplant risk stratification based on antidonor antibody titer may be of limited value. Splenectomy, previously reported to be an important component of ABO incompatible transplantation, appears to be avoidable under many circumstances. The wider implementation of A2 blood group incompatible transplantation shortens waiting time for deceased donor transplantation of blood group B recipients without significantly disadvantaging others. The diagnosis of acute humoral rejection has become clearer following the recognition that C4d deposition commonly occurs in well functioning ABO incompatible allografts. The long-term implications of acute humoral rejection appear substantial even following successful acute therapy, with a significant percentage of patients developing chronic humoral rejection manifested as transplant glomerulopathy. Finally, although ABO incompatible transplantation entails increased expense, when compared with maintenance dialysis and taking into account the health related quality of life benefits of a successful transplant, it is clearly cost effective. SUMMARY: ABO incompatible kidney transplantation is an effective therapy, and will become more widely implemented in the future.
KW - ABO incompatible
KW - Kidney transplantation
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U2 - 10.1097/MNH.0b013e3282f02218
DO - 10.1097/MNH.0b013e3282f02218
M3 - Article
VL - 16
SP - 529
EP - 534
JO - Current Opinion in Nephrology and Hypertension
JF - Current Opinion in Nephrology and Hypertension
SN - 1062-4821
IS - 6
ER -