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Latest insights on ABO‐incompatible living‐donor renal transplantation
Author(s) -
Uchida Junji,
Kosoku Akihiro,
Naganuma Toshihide,
Tanaka Tomoaki,
Nakatani Tatsuya
Publication year - 2020
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14109
Subject(s) - medicine , abo blood group system , contraindication , transplantation , kidney transplantation , plasmapheresis , dialysis , desensitization (medicine) , end stage renal disease , kidney , renal replacement therapy , disease , intensive care medicine , surgery , immunology , antibody , pathology , alternative medicine , receptor
This review summarizes the latest insights on ABO‐incompatible living‐donor renal transplantation. Desensitization protocols and clinical outcomes were investigated, and a comparison was made with kidney‐paired donation, which is not permitted in Japan for ethical reasons. Although renal transplantation is greatly beneficial for most patients with end‐stage kidney disease, many of these patients must remain on dialysis therapy for extended periods due to the scarcity of organs from deceased donors. ABO blood type incompatibility was once believed to be a contraindication to renal transplantation due to the increased risk for antibody‐mediated rejection and early graft loss attributable to isoagglutinins. Recently, pretransplant desensitization strategies, such as removal of isoagglutinins and antibody‐producing cells, have achieved successful outcomes, although it remains unclear whether graft survival and patient morbidity are equivalent to those for ABO‐compatible renal transplantation. The present review suggested that ABO‐incompatible living‐donor renal transplantation might be a favorable radical renal replacement therapy for patients with end‐stage kidney disease.