"Blood Type 'Incompatible' Kidney Transplantation Effective Even for Elderly Renal Failure Patients"

Research by Professor Heo Gyuha of Severance Transplant Surgery and Professor Kim Deokgi's Team at Wonju Severance Christian Hospital

[Asia Economy Reporter Kim Ji-hee] A study has found that transplanting kidneys with different blood types into elderly patients aged 60 and over with end-stage renal failure shows no difference in graft survival compared to kidney transplants from deceased donors, and in fact, patient survival rates after transplantation are higher. This is expected to provide a new treatment option for elderly patients who have had to wait a long time to receive kidneys from deceased donors.

Professor Heo Gyu-ha of the Department of Transplant Surgery at Yonsei University Severance Hospital and Professor Kim Deok-gi’s team at Wonju Severance Christian Hospital analyzed data from the Korean Organ Transplantation Registry (KOTRY) on 634 elderly patients aged 60 and above who underwent kidney transplantation between August 2014 and December 2017, and announced these findings on the 20th. They compared the post-transplant outcomes of ABO-incompatible living donor kidney transplantation (Group A, 80 patients) with ABO-compatible living donor kidney transplantation (Group B, 222 patients) and deceased donor kidney transplantation (Group C, 332 patients).

The results showed that the frequency of rejection after ABO-incompatible kidney transplantation was not significantly different compared to ABO-compatible (Group B) and deceased donor (Group C) kidney transplantation. Regarding graft function, ABO-incompatible kidney transplantation (Group A) showed slightly lower function than ABO-compatible transplantation (Group B), but higher function compared to deceased donor transplantation (Group C).

There was no difference in graft survival among Groups A, B, and C. The annual mortality rate after transplantation was 0.5% in Group A (ABO-incompatible), which was not significantly different from 0.3% in Group B (ABO-compatible), and was lower than 1.5% in Group C (deceased donor).

Elderly patients with end-stage renal failure must undergo dialysis if they cannot receive a kidney transplant. If there is no suitable donor among family members, they can receive a kidney from a deceased donor, but the average waiting period from registration to transplantation is about seven years.

If a suitable donor is available, receiving a kidney transplant quickly is more effective than dialysis in terms of patient survival, quality of life, and cost. Especially for elderly patients, preparing for transplantation quickly increases the likelihood of successful kidney transplantation. Accordingly, ABO-incompatible kidney transplantation has recently been performed at many medical institutions in Korea. However, there have been no reports on the outcomes or complications of ABO-incompatible kidney transplantation in elderly patients with end-stage renal failure.

Professor Heo said, “For elderly patients with end-stage renal failure who have a living donor with an incompatible blood type, actively undergoing ABO-incompatible kidney transplantation after treatments such as plasmapheresis, rather than waiting for a deceased donor kidney transplant, can be expected to improve patient survival.”

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