What is ABO Incompatible Kidney Transplantation ?
An ABO incompatible kidney transplant is a type of transplant where the donor and recipient have incompatible blood types, which historically would have made transplantation impossible due to immediate immune rejection. However, with medical advancements, it is now possible to perform kidney transplants across blood group barriers by removing antibodies that would otherwise attack the donated kidney. This type of transplant is an option when a blood group-compatible living donor is unavailable and a lengthy wait for a deceased donor kidney is not ideal.
When is ABO Incompatible Kidney Transplant Necessary?
An ABO incompatible transplant becomes necessary when a blood group compatible donor is not available, and the patient cannot wait on the deceased donor list due to the long waiting period, which can be around four years. Related donors are generally preferred as they provide excellent genetic matching, reducing rejection risk and offering a longer lifespan for the transplanted kidney. However, in the absence of a blood group-compatible related donor, ABO incompatible transplantation is considered.
ABO Incompatible Kidney Transplant Protocol
Previously, ABO incompatibility was an absolute barrier to transplantation due to the risk of immediate rejection. Now, thanks to medical advancements, transplanting across blood groups is feasible. The protocol involves two main processes: removing existing antibodies and preventing antibody rebound. Methods to remove antibodies include plasmapheresis, double filtration plasmapheresis (DFPP) and Immunoadsorption. In plasmapheresis, around 3-4 liters of plasma containing antibodies are removed and replaced by plasma or albumin.
click for compatible blood groupsComparison with Blood Group Compatible Transplants
The primary difference between ABO incompatible and compatible transplants lies in the preparatory procedures before surgery. Despite these extra steps, after transplantation, the risks of rejection, infection, and kidney longevity are similar in both ABO compatible and incompatible transplants.
click for blood groups and antibodiesGlobal Practices and Outcomes
ABO incompatible transplants are now routinely performed worldwide, with countries such as Sweden, Germany, the USA, and Japan leading in these procedures. While the first cadaveric kidney transplantation was conducted in the USA in 1950, ABO-incompatible transplants began in the 1970s. Initial attempts faced challenges due to hyperacute rejection, but Japan, facing a severe shortage of deceased donor organs, pioneered successful ABO-incompatible transplants. Data from Japan and more recent studies in Europe and the USA show excellent long-term outcomes for ABO-incompatible living donor kidney transplants.
Cost Considerations
Across the world ABO incompatible transplantations are being done regularly in Sweden, Germany, USA and Japan. The first cadaveric kidney transplantation was performed in USA in 1950. ABO-incompatible transplantation was already performed as early as in the 1970s, but due to hyperacute rejection, the results were discouraging. But, due to a severe shortage of available deceased donor organs, most ABO-incompatible kidney transplantations have taken place in Japan. Published data demonstrate an excellent long-term outcome of ABO-incompatible living donor kidney patients in Japan. Similar successful short-term results have been shown for protocols developed in Europe and the United States.
ABO Incompatible Kidney Transplantation Transplant in India
If you’re exploring an ABO incompatible kidney transplant due to chronic kidney disease or end-stage renal failure, expert guidance is crucial for a successful outcome. Dr. Kamal Kiran specializes in ABO incompatible kidney transplants, offering tailored treatment plans designed to address your unique needs. With advanced techniques to manage blood group incompatibility and a focus on both pre-surgery and post-surgery care, Dr. Kamal Kiran ensures a high success rate and a smooth transition to a healthier, dialysis-free life. Discover the life-changing benefits of ABO incompatible kidney transplantation—schedule your consultation with Dr. Kamal Kiran today.
