Impact of Rh(D) Blood Group System on Graft Function and Survival in Live-Donor Kidney Transplantation: A Single-Institution Experience

Abstract

One thousand five hundred consecutive live-donor renal transplants were performed in a single institution. Among these patients, 1,372 patients (group I) received Rh-identical allografts and 128 (group II) received Rh-nonidentical allografts. The two groups were homogenous apart from the prevalence of the Rh nonidentity among unrelated donor-recipient pairs. The rate of acute and chronic rejection was comparable in both groups (P = 0.33 for acute rejection and P = 0.66 for chronic rejection). The mean serum creatinine at 5 years was 1.8 +/- 1 mg/dL for group I and 1.7 +/- 0.9 mg/dL for group II (P = 0.5). The 1-, 5-, and 10-year graft survival rates were 94%, 78%, and 54% for group I and 95%, 82%, and 57% for group II. We found that the Rh(D) blood group system is not likely to be a clinically relevant histocompatibility barrier to live-donor renal transplantation.

Duffy and Kidd blood group antigens: minor histocompatibility antigens involved in renal allograft rejection?

“…A recent study by Osman and associates 48 could not show any impact of D mismatching on renal allograft rejection 48 . This result was expected because D—unlike FY and JK—is not expressed in the kidney and the homologous nonerythroid D proteins expressed in the kidney, RhBG and RhCG, are not polymorphic 49 …”

Massive Immune Hemolysis Caused by Anti‐D After Dual Kidney Transplantation

“…Whether or not the dose of passenger lymphocytes contributed either to the timing, severity or subsequent development of immune hemolysis in our patient is highly conjectural but interesting to speculate nonetheless. A recent retrospective review concluded that Rh(D) blood group is not likely a clinically relevant histocompatibility barrier in live‐donor renal transplantation (9). In this review, 58 patients (4%) over 20 years had received minor Rh(D) mismatched transplants and the effect was described as mild.…”