ABO-incompatible living-donor pediatric kidney transplantation in Japan

Abstract

The Japanese ABO-Incompatible Transplantation Committee officially collected and analyzed data on pediatric ABO-incompatible living-donor kidney transplantation in July 2012. The age of a child was defined as <16 years, and 89 children who had undergone ABO-incompatible living-donor kidney transplantation from 1989 to 2011 were entered in a registry. These data were presented as the Japanese registry of pediatric ABO-incompatible living-donor kidney transplantation at the regional meetings of the International Pediatric Transplantation Association (IPTA) in Nagoya in September 2012 and in Sao Paulo in November 2012.

Outcomes, complications, and economic impact of ABO‐incompatible living kidney transplantation: A single‐center Japanese cohort study

“…[1][2][3][4] Recently, ABO-ILKT has been performed as a routine practice and constituted nearly 30% of living kidney transplantation performed in Japan. In 1987, however, successful ABO-ILKT was introduced in Japan, using pre-transplant antibody depletion.…”

“…In 1987, however, successful ABO-ILKT was introduced in Japan, using pre-transplant antibody depletion. [1][2][3][4] Recently, ABO-ILKT has been performed as a routine practice and constituted nearly 30% of living kidney transplantation performed in Japan. The substantial improvements of ABO-ILKT were demonstrated in relation to the graft survival rate, the frequency of infectious adverse events, and renal function over time.…”

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“…Overall, patient and graft survival rates in the 89 pediatric cases of ABOi were 99% and 94% at 1 year, 99% and 93% at 3 years, 97% and 90% at 5 years, 97% and 80% at 10 years, and 81% and 68% at 20 years after transplantation (Figure 7). 10 In contrast, graft survival rates in 2129 adult cases of ABOi (age > 16 y) were 93% at 1 year, 89% at 3 years, 85% at 5 years, 70% at 10 years, and 50% at 20 years after transplantation (Figure 8). Graft survival rates were significantly better in the pediatric than adult cases of ABOi (P ≤ .05) (Figure 8).…”

“…Graft survival rates were significantly better in the pediatric than adult cases of ABOi (P ≤ .05) (Figure 8). 10 Based on these good results, ABOi is indicated in children with end-stage renal failure. Although deceased-donor kidney transplantation is beneficial for children in any country, ABOi should be considered when the patients want preemptive kidney transplantation or the waiting time for deceased-donor kidney transplantation is very long.…”

Economic Impacts of ABO-Incompatible Live Donor Kidney Transplantation: A National Study of Medicare-Insured Recipients

“…Kidney transplantation across blood group incompatibilities was initially believed to result in universal hyperacute rejection of the allograft and subsequent graft loss. In 1987, however, successful live donor ABO‐incompatible (ABOi) transplantation was introduced in Japan, using pretransplant antibody depletion to expand access to transplantation in the absence of legal recognition of brain death . Since that time, ABOi transplantation has evolved into routine practice and constituted nearly 14% of living donor transplant procedures performed in Japan in 2011.…”