ABO incompatible renal transplants: Good or bad?

Table 2 Historical clinical reports in ABO incompatible kidney transplantation

Ref.	Type of study	Study population	ABOi population	Desensitization	Outcome
Hume et al[18]	Observational	9	1	No treatment	Graft nephrectomy day 17
Starzl et al[19]	Observational	3	2	SPx (1 case)	Graft survival 74 d (1 case), patient death day 24 (1 case)
Sheil et al[20]	Observational	2	2	No treatment	Graft nephrectomy day 14
Alexandre et al[11]	Observational	23	23	PE/SPx	2-yr graft survival: 88% (related donor), 50% (unrelated donor)
Ota et al[21]	Observational, comparative	51	51	DFPP and/or IAs/SPx	2-yr graft survival: 87% vs 84.6% vs 50% ( A- vs B- vs ABO-incompatible)
Tanabe et al[22]	Observational, comparative	433	67	DFPP and IAs/SPx	8-yr graft survival: 73% vs 80 % (ABOi vs ABOc)
Ishida et al[23]	Observational	93	93	DFPP/SPx	5-yr graft survival: 73%
Ohta et al[24]	Observational, pediatric	10	10	DFPP or PE or IAs/SPx	5.4-yr graft survival: 100%
Shishido et al[25]	Observational, pediatric	16	16	PE and IAs/SPx	5-yr graft survival: 85%
Takahashi et al[2]	Observational, comparative	1496	441	DFPP or PE or IAs/SPx	9-yr graft survival: 59% vs 57% (ABOi vs ABOc)
Shimmura et al[26]	Observational, comparative	167	167	DFPP and/or IAs/SPx	5-yr graft survival: 74.3% vs 78.5% ( CYA with AZ or MZ vs TAC or MMF)
Futagawa et al[27]	Observational, comparative	37803	191	NA	5-yr graft survival: 66.2% vs 79.5% (ABOi vs ABOc)
Ishida et al[28]	Observational, comparative	222	222	DFPP/SPx	5-yr graft survival: 73% vs 90% ( CYA with AZ vs TAC with MMF)
Tyden et al[29]	Observational, comparative	334	60	IAs/RIT/IVIG	Graft survival: ABOi 97% (1.5-yr) vs ABOc 95% (1.8-yr)
Galliford et al[30]	Observational	10	10	PE/RIT/IVIG	1-yr graft survival: 100%
Genberg et al[31]	Observational, comparative	45	15	IAs/RIT/IVIG	Graft survival: ABOi 86.7% (3.4-yr) vs ABOc 86.7% (4.0-yr)
Oettl et al[32]	Observational	10	10	IAs/RIT/IVIG	1.3-yr graft survival: 100%
Toki et al[33]	Observational, comparative	57	57	DFPP/SPx	8-yr graft survival: 49% vs 95% (AAMR vs non-AAMR)
Wilpert et al[34]	Observational, comparative	83	40	IAs/RIT/IVIG	Graft survival: ABOi 100% (3.3-yr) vs ABOc 93% (1.5-yr)
Tyden et al[1]	Observational, comparative, pediatric	38	10	IAs/RIT/IVIG	Graft loss within 3 years: ABOi 1 case, ABOc 2 cases
Flint et al[35]	Observational, comparative	89	37	PE/IVIG	1-yr graft survival: 100% (ABOi vs ABOc)
Fichinoue et al[36]	Observational, comparative	393	113	DFPP or PE/SPx or RIT	5-yr graft survival: 88.4% vs 90.3% vs 100% (ABOc vs ABOi-SPx vs ABOi-RIT)
Habicht et al[37]	Observational, comparative	68	21	IAs/RIT/IVIG	1-yr graft survival : 100% (ABOi vs ABOc)
Lipshutz et al[38]	Observational	18	18	PE/RIT/IVIG	1-yr graft survival: 94.4%
Shirakawa et al[39]	Observational, comparative	74	74	DFPP/RIT	1-yr graft survival: 95.7% vs 98.% ( RIT 500mg vs RIT 200 mg)
Shishido et al[3]	Observational, comparative, pediatric	323	52	PE/SPx or RIT	15-yr graft survival: 86% vs 78% (ABOi vs ABOc)
Montgomery et al[4]	Observational, comparative	78193	738	NA	10-yr cumulative incidence of graft loss: 27.1% vs 23.9% (ABOi vs ABOc)
Morath et al[40]	Observational, comparative	19	19	IAs or IAns/RIT/IVIG	1-yr graft survival: 100% (IAs vs IAns)
Uchida et al[41]	Observational	25	25	DFPP or PE/SPx or RIT	4.5-yr graft survival: 100%
Ashimine et al[42]	Observational, comparative	320	92	DFPP/SPx or RIT or none	5-yr graft survival: 87% vs 97.7% (ABOi vs ABOc)

ABOi: ABO incompatible; SPx: Splenectomy; PE: Plasma exchange; DFPP: Double-filtration plasmapheresis; IAs: Antigen-specific immunoadsorption; ABOc: ABO compatible; CYA: Cyclosporine; AZ: Azathioprine; MZ: Mizoribine; TAC: Tacrolimus; MMF: Mycophenolate mofetil; NA: Not available; RIT: Rituximab; IVIG: Intravenous immunoglobulin; AAMR: Acute antibody-mediated rejection; IAns: Non-antigen-specific immunoadsorption.