Abo incompatiblerenal transplantation -our institutional experience

Introduction: ABO incompatible Kidney Transplant (ABOi-Kidney Transplant) was previously considered to be an absolute contraindication for patients with end-stage kidney disease (ESKD) due to hyperacute rejection related to immunological barrier. Intensified immunosuppression and immunological understanding has helped to shape current desensitization protocols. This study provides an overview of the history, outcome, protocol, advantages and disadvantages in ABOi-Kidney Transplant.
Aim of The Study: To define
• Desensitization modalities and protocols for ABO Incompatible Kidney Transplant and Post-transplant immunologic surveillance.
• Factor affecting Antibody-mediated rejection in ABO incompatible kidney allograft transplantation. And Outcome of ABO incompatible kidney allograft transplant.
Materials and Methods: This is a retrospective and prospective analysis of case series of ABO in Kidney Transplant which were done in our institute (KILPAUK MEDICAL COLLEGE HOSPITAL) from August 2015 to March 2019.Total 6 cases of ABO incompatible Kidney Transplant were done. Preop and post op protocol defined and strictly follow during the study, vessels and ureteric anastomosis done as per standard technique. Success rate or outcome is measured in term of graft survival or graft rejection.
Results /Outcome: In our institute all the six patients were strictly evaluated pre operatively and post operatively. The creatinine came down to less than 2 mg /dl within 4 th POD and the urine output was adequate for all the six patients .No patients were required hemodialysis post operatively in more than 2.5 year follow up .No graft biopsy done till date. There was no signs and symptoms of rejection to any patients. All the six patients are under follow.
Conclusion: As the pre-transplant and post-transplant desensitization protocols have developed and changed in many different fields, satisfactory results have been observed. The allograft outcomes have been enhanced. Graft survival is comparative to ABO compatible transplant. It is good option to increase the donor pool, especially country like India where cadaver Kidney Transplant is still low.