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J Nephropathol. 2016 Jan;5(1):19-27. doi: 10.15171/jnp.2016.04. Epub 2015 Dec 30.

Early post-transplant complications following ABO-incompatible kidney transplantation.

Author information

1
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
2
Department of Urology, Andrology, and Transplantation, CHU Rangueil, Toulouse, France.
3
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France ; Department of Urology, Andrology, and Transplantation, CHU Rangueil, Toulouse, France.
4
Etablissement Français du Sang de Midi-Pyrénées, CHU Purpan, Toulouse, France.
5
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France ; INSERM U563, IFR-BMT, CHU Purpan, Toulouse, France ; Université Paul Sabatier, Toulouse, France.

Abstract

BACKGROUND:

Living-kidney transplantation is increasing because of the scarcity of kidneys from deceased donors and the increasing numbers of patients on waiting lists for a kidney transplant. Living-kidney transplantation is now associated with increased long-term patient- and allograft-survival rates.

OBJECTIVES:

The purpose of this retrospective study was to identify, in a cohort of 44 ABO-incompatible (ABOi) live-kidney transplant patients, the main complications that occurred within 6 months post-transplantation, and to compare these findings with those from 44 matched ABO-compatible (ABOc) live-kidney transplant patients who were also from our center.

PATIENTS AND METHODS:

This single-center retrospective study assessed post-transplantation complications in 44 ABO-i versus 44 matched ABO-c patients. All patients were comparable at baseline except that ABO-i patients had greater immunological risks.

RESULTS:

During the 6-month post-transplant period, more ABO-i patients presented with postoperative bleeds, thus requiring significantly more blood transfusions. Bleeds were associated with significantly lower values of fibrinogen, platelets, prothrombin time, and hemoglobin levels. Surgical complications, patient- and graft-survival rates, and kidney-function statuses were similar between both groups at 6 months post-transplantation.

CONCLUSIONS:

We conclude that impairment of hemostatic factors at pre-transplant explained the increased risk of a post-transplant bleed in ABO-i patients.

KEYWORDS:

BK virus; Bleeding; Blood transfusion; Fibrinogen; Kidney transplantation; Surgical complications

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