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World J Transplant. Sep 18, 2021; 11(9): 388-399
Published online Sep 18, 2021. doi: 10.5500/wjt.v11.i9.388
ABO incompatibility in renal transplantation
Mahmoud Mohamed, Tara Sweeney, Duaa Alkhader, Mahmoud Nassar, Ahmed Alqassieh, Sofia Lakhdar, Nso Nso, Tibor Fülöp, Ahmed Daoud, Karim M Soliman
Mahmoud Mohamed, Department of Medicine, North Mississippi Medical Center, Tupelo, MS 38804, United States
Tara Sweeney, Tibor Fülöp, Karim M Soliman, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
Duaa Alkhader, Ahmed Alqassieh, Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, United States
Mahmoud Nassar, Sofia Lakhdar, Nso Nso, Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, New York, NY 11432, United States
Ahmed Daoud, Department of Medicine, Kasr Alainy Medical School, Cairo University, Cairo 11562, Egypt
Author contributions: Mohamed M, Sweeney T, Alkhader D, Alqassieh A, and Nassar M participated in writing the manuscript; Fülöp T, Daoud A, and Soliman KM reviewed the manuscript.
Conflict-of-interest statement: Authors state there is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Karim M Soliman, MBChB, MD, MSc, Assistant Professor, Staff Physician, Department of Medicine, Medical University of South Carolina, 96 Jonathan Lucas St., Charleston, SC 29425, United States. drkarimsoliman@gmail.com
Received: March 6, 2021
Peer-review started: March 8, 2021
First decision: May 5, 2021
Revised: May 19, 2021
Accepted: September 1, 2021
Article in press: September 1, 2021
Published online: September 18, 2021
Processing time: 192 Days and 8.8 Hours
Abstract

ABO blood group incompatibility (ABO-I) was historically considered an absolute contraindication to kidney transplantation due to the significant risk of acute antibody-mediated rejection and early graft loss. Nevertheless, the urge to minimize the gap between the candidates’ number on the waitlist for kidney transplants and the available kidney donors encourage investigation into finding ways to use organs from ABO-I kidney donors, especially in the era of using more potent immunosuppression therapies. This review aims to discuss a general overview of ABO-I kidney transplantation and the different protocols adopted by some transplant centers to meaningfully overcome this barrier.

Keywords: ABO incompatibility; Renal transplantation; Kidney; Transplants

Core Tip: The urge to minimize the gap between the candidates’ number on the waitlist for kidney transplants and the available kidney donors encouraged investigations into finding ways to use organs from ABO blood group incompatibility (ABO-I) kidney donors, especially in the era of using more potent immunosuppression therapies. In this review, we aim to discuss a general overview of ABO-I kidney transplantation and the different protocols adopted by some transplant centers to overcome this barrier.