Excellent outcomes of ABO-incompatible kidney transplantation: a single-center experience

Transplant Proc. 2012 Jan;44(1):204-9. doi: 10.1016/j.transproceed.2011.11.006.


Introduction: Due to the severe shortage of deceased donors in Japan, ABO-incompatible living donor kidney transplantation has been performed since the late 1980s. Excellent long-term outcomes have been achieved; the rates of graft survival among these patients are currently similar to those of recipients of ABO-compatible grafts. Our single-center experience describing the immunosuppressive protocols, complications, and grafts survivals is documented in this study.

Patients and methods: Among 123 patients with end-stage renal disease who underwent living donor kidney transplantation between January 1999 and December 2010, 25 cases were ABO-incompatible grafts. All of these patients were followed until August 2011. Analyzing these patients, we focused on their immunosuppressive protocols, complications, and graft survivals.

Results: Patient and graft survival rates were 100%. One patient experienced antibody-mediated rejection and an intractable acute cellular rejection episode, 1 patient an antibody-mediated rejection, and 6 patients had acute cellular rejection episodes. However, there were no severe complications.

Conclusion: Although ABO-incompatible kidney transplantation is a high-risk procedure, a short-term graft survival rate of 100% may be expected due to recent significant improvements in desensitization and recipient management.

MeSH terms

  • ABO Blood-Group System / immunology*
  • Adult
  • Blood Group Incompatibility / immunology*
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / virology
  • Desensitization, Immunologic / methods
  • Female
  • Graft Rejection / immunology
  • Graft Rejection / prevention & control
  • Graft Survival
  • Histocompatibility*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Japan
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Time Factors
  • Treatment Outcome


  • ABO Blood-Group System
  • Immunosuppressive Agents