AUTHOR=Obeid Dalia A. , Broering Dieter C. , AlMeshari Khalid A. , Shah Yaser Z. , Aleid Hassan A. , AlManea Hadeel M. , AlAbassi Amira M. , AlMozain Nour , Marquez Kris , Alsaadi Eman A. , Ali Tariq Z. 

TITLE=Impact of different blood group incompatibilities in kidney transplantation: a 15-year outcomes analysis from a large kidney transplant center

JOURNAL=Frontiers in Transplantation

VOLUME=Volume 4 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/transplantation/articles/10.3389/frtra.2025.1690999

DOI=10.3389/frtra.2025.1690999

ISSN=2813-2440

ABSTRACT=BackgroundWhile ABO-incompatible kidney transplantation (ABOiKT) has demonstrated favorable short-term outcomes, data on its long-term effects remain limited. This study evaluated the short- and long-term clinical outcomes of ABOiKT across various ABO-incompatible donor–recipient combinations.MethodsWe included patients who underwent ABOiKT at our institution in 2007–2024. The outcomes assessed included 15-year data on graft, patient survival, and early AMR rates.ResultsOf 239 ABOiKT cases, AMR occurred in 9.2% and was linked to longer hospitalization and higher graft failure. AMR was most frequent in B–O (20.3%) and A1–O (13.3%) transplants but no cases of AMR were observed in the recipients of kidneys from A2 donors. B to O mismatch significantly increased the risk of AMR-related graft loss. Patient survival was 99.1% at 1 year and 86.2% at 15 years and Graft survival was 92.7% and 87.5% respectively.ConclusionsOur study showed favorable outcomes of ABOiKT across different mismatch types. As the largest ABOiKT study in the Middle East with extended follow-up, our study provides important regional insights and contribute significantly to the global understanding of ABOiKT outcomes.