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#54-OR
THE 9-YEAR SURVIVAL OF KIDNEYS FROM BLOOD GROUP A2/A2B DECEASED DONORS IS THE SAME AS THAT OF B DONORS WHEN TRANSPLANTED INTO B PATIENTS.
Christopher Bryan, Ph.D., HCLD, Franz Winklhofer, M.D., Daniel Murillo, M.D., Gilbert Ross, M.D., Paul Nelson, M.D., Charles Shield, III, M.D. and Bradley Warady, M.D.. Westwood Kansas, USA, Midwest Transplant Network, 66205, HLA Laboratory.
Purpose: The long-term (>5 years) graft survival of kidneys from blood group A2/A2B donors in comparison to kidneys from blood group B donors when transplanted into B recipients is unknown. Objective: We evaluated the graft survival of all blood group B deceased donor recipients (n=179) who were transplanted by the six renal transplant centers in our OPO from 1994 through 2003. We compared the graft survival of the 56 B recipients who were transplanted with an A2 (n=51) or A2B (n=5) kidney with the 123 B recipients who received a kidney from a B donor. Blood group B patients only received an A2/A2B kidney if they had a low (<8) anti-A IgG titer history. Immunosuppression was center directed, but no pre-or perioperative treatment such as IVIg, plasmapheresis, or spleenectomy was given to lower the anti-A IgG titer. Results: The data in the following table show that 9-year graft survival (died with functioning graft censored) of kidneys from A2/A2B donors is not significantly different from that of kidneys from blood group B donors (log-rank=0.6).
1 3 5 7 9 A2 → B 94% 85% 78% 71% 71% (n=56) B → B 92% 85% 76% 72% 65% (n=123)
Conclusions: These data establish that the clinical immunogenecity, as judged by 9-year graft outcome, of kidneys from A2/A2B donors is no different from that of B donors, and challenge us to consider using A2/A2B donor transplantation into B recipients to increase the access to kidneys, especially in minorities such as black and Asian patient groups where the frequency of those who are blood group B is much higher (19% in blacks and 25% in Asians) than in whites (9%).