Patient and Graft Survival After A1/A2-incompatible Living Donor Kidney Transplantation.
Patient and Graft Survival After A1/A2-incompatible Living Donor Kidney Transplantation.
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DOI：
10.1097/txd.0000000000001388
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发表时间：
2022-11
影响因子：
2.3
通讯作者：
中科院分区：
文献类型：
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ABO B型和O型肾移植候选人在确定活体肾移植（LDKT）的相容供体方面越来越困难，并且在肾配对捐赠登记中更难匹配。A2不相容（A2 i）LDKT增加了这些患者获得LDKT的机会。为了更好地为活体供体选择提供信息，我们评估了A2 i LDKT与患者和移植物存活率之间的相关性。我们使用加权考克斯回归来比较A2 i与ABO相容（ABOc）受体的死亡率、死亡删失的移植失败和全因移植失败。使用2000-2019年移植受体科学登记数据，我们确定了345名A2 i LDKT受体。A2 i和ABOc受体的死亡率相当; A2 i LDKT受体的加权1-/5-/10年死亡率分别为0.9%/6.5%/24.2%，而ABOc LDKT受体分别为1.4%/7.7%/22.2%（加权风险比[wHR]，0.811.041.33; P = 0.8）。然而，A2 i受体面临更高的死亡删失移植失败风险; A2 i受体的加权1年/5年/10年移植失败率为5.7%/11.6%/22.4%，而ABOc受体为1.7%/7.5%/17.2（第1年的wHR = 2.243.565.66;第5年= 1.251.782.53;第10年= 1.151.552.07）。相比之下，A1不相容受体的1-/5-/10-y wHR为0.631.966.08/0.390.942.27/0.390.831.74。A2 i LDKT通常是安全的，但应告知A2 i供体/受体对移植失败的风险增加，并在移植后与A1不相容的供体/受体一样密切监测。
ABO type B and O kidney transplant candidates have increased difficulty identifying a compatible donor for living donor kidney transplantation (LDKT) and are harder to match in kidney paired donation registries. A2-incompatible (A2i) LDKT increases access to LDKT for these patients. To better inform living donor selection, we evaluated the association between A2i LDKT and patient and graft survival. We used weighted Cox regression to compare mortality, death-censored graft failure, and all-cause graft loss in A2i versus ABO-compatible (ABOc) recipients. Using Scientific Registry of Transplant Recipients data 2000–2019, we identified 345 A2i LDKT recipients. Mortality was comparable among A2i and ABOc recipients; weighted 1-/5-/10-y mortality was 0.9%/6.5%/24.2%, respectively, among A2i LDKT recipients versus 1.4%/7.7%/22.2%, respectively, among ABOc LDKT recipients (weighted hazard ratio [wHR], 0.811.041.33; P = 0.8). However, A2i recipients faced higher risk of death-censored graft failure; weighted 1-/5-/10-y graft failure was 5.7%/11.6%/22.4% for A2i versus 1.7%/7.5%/17.2% for ABOc recipients (wHR in year 1 = 2.243.565.66; through year 5 = 1.251.782.53; through year 10 = 1.151.552.07). By comparison, 1-/5-/10-y wHRs for A1-incompatible recipients were 0.631.966.08/0.390.942.27/0.390.831.74. A2i LDKT is generally safe, but A2i donor/recipient pairs should be counseled about the increased risk of graft failure and be monitored as closely as their A1-incompatible counterparts posttransplant.
DOI：
10.1111/ajt.15046
发表时间：
2018-11
期刊：
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子：
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作者：
Holscher CM;Jackson K;Thomas AG;Haugen CE;DiBrito SR;Covarrubias K;Gentry SE;Ronin M;Waterman AD;Massie AB;Garonzik Wang J;Segev DL
通讯作者：
Segev DL
DOI：
10.1111/ajt.14689
发表时间：
2018-06
期刊：
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子：
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作者：
Holscher CM;Jackson K;Chow EKH;Thomas AG;Haugen CE;DiBrito SR;Purcell C;Ronin M;Waterman AD;Garonzik Wang J;Massie AB;Gentry SE;Segev DL
通讯作者：
Segev DL