Ongoing higher infection rate in ABO-incompatible kidney transplant recipient: is it a serious problem? A single-center experience.
10.4174/astr.2016.91.1.37
- Author:
Byung Hyun CHOI
1
;
Duck Jong HAN
Author Information
1. Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
- Publication Type:Original Article
- Keywords:
ABO incompatibility;
Kidney transplantation;
Infection
- MeSH:
BK Virus;
Cytomegalovirus;
Female;
Graft Survival;
Humans;
Kidney Transplantation;
Kidney*;
Pneumonia;
Risk Factors;
Transplant Recipients*;
Urinary Tract Infections
- From:Annals of Surgical Treatment and Research
2016;91(1):37-44
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Additional clinical experience and knowledge regarding the barrier to transplantation of ABO blood type incompatibility could reduce the higher rate of infectious complications in ABO-incompatible kidney transplantation. METHODS: A total of 79 ABO-incompatible kidney transplantation (ABOiKT) patients were compared with 260 ABO-compatible kidney transplantation (ABOcKT) patients for basic clinical characteristics, infectious complications, rejection episodes, and graft survival. RESULTS: There were no significant differences in baseline characteristics, rejection rates, or graft survival between the ABOiKT and ABOcKT patients. No significant difference in the infection rate was shown for cytomegalovirus (26.6% vs. 30.0%; P = 0.672), BK virus (19.0% vs. 21.5%; P = 0.752), herpes disease (10.1% vs. 5.0%; P = 0.082), pneumonia (5.3% vs. 3.8%; P = 0.746), or urinary tract infection (8.9% vs. 10.0%; P > 0.999). Female sex (hazard ratio [HR], 2.20; P = 0.003), advanced age (≥60 years) (HR, 2.5; P = 0.019), history of rejection episodes (HR, 2.28; P = 0.016), and history of surgical complications (HR, 4.64; P = 0.018) were significant risk factors for infection. ABO incompatibility demonstrated a tendency toward higher infection risk without statistical significance (HR, 1.74; P = 0.056). CONCLUSION: In spite of immunosuppressant protocol modification, the rate of infectious complications following ABOiKT is still higher than with ABOcKT when a modified desensitization protocol is used. However, this was not sufficient to avoid ABOiKT.
