Abstract: TH-PO0905
Long-Term Effect of Human Leukocyte Antigen (HLA) Sensitization on Patient and Graft Outcomes in ABO-Incompatible Living-Donor Kidney Transplantation
Session Information
- Transplantation: Clinical - Glomerular Diseases, Infections, and Rejection
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Prasad, Narayan, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
- V, Jeykumar, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
Background
ABOi KT outcomes study showed comparable long-term outcomes with ABO-compatible (ABOc); however, data is limited on effects of HLA sensitization in ABOi KT recipients. We studied impact of HLA sensitization on long term graft and patient survival following ABOi KT.
Methods
The prospective study included ABOi KT (≥12 years) performed between Jan 2014 and Dec 2023. Desensitization involved rituximab, plasmapheresis, and IVIg to achieve anti-ABO titers ≤1:8. Induction (basiliximab or ATG) was risk-based. Demographics, immunological risk, desensitization, immunosuppression, BPAR and infection outcomes, with and without HLA sensitization were analyzed. Outcomes parameters BPAR, patient/graft survival at 1, 3, 5, and 10 years and serious infections requiring hospitalization(SIRH) were compared between HLA sensitized and non-sensitized ABOi KT .
Results
Among 184 ABOi KT;74 HLA-sensitized with donor specific antibodies, and 110 non-HLA-sensitized. Sensitized patients had more repeat transplants (13.5% vs 0.9%, p<0.001) and higher DSA positivity (Class I: 27% vs 5.5%; Class II: 82.4% vs. 10%, both p=0.001) and higher ATG induction in sensitized patients (28.4% vs 11.8% p=0.005). BPAR, immediate and delayed graft function were similar (Figure 1). SIRH were also similar (31.1% vs. 43.6%, p=0.080). Five and 10 year patient and graft survival were similar (88.6% vs. 83%, p=0.39; 85.7% vs. 80% p=0.23) Figure 2.
Conclusion
There were no difference in rejection, graft, or patient survival between HLA-sensitized and non-sensitized groups. Ten-year graft survival were similar between two groups.
Outcomes between the HLA sensitised and nonsensitised patients with ABOi KT
KM graft survival of ABOi KT with and without HLA sensitisation
Funding
- Government Support – Non-U.S.