ORIGINAL RESEARCH article
Front. Transplant.
Sec. Abdominal Transplantation
Impact of Different Blood Group Incompatibilities in Kidney Transplantation: A 15-Year Outcomes Analysis from a Large Kidney Transplant Center
Provisionally accepted
Dalia Obeid
DIETER BROERING
Khalid A AlmeshariYaser Z ShahHassan A AleidHadeel M AlmaneaAmira M AlabassiNour Almozain
Kris MarquezEman A Alsaadi
Tariq Z Ali*- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Background: While 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. Methods: We 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. Results: Of 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. Conclusions: Our 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.
Keywords: ABO-incompatible transplantation, Antibody-mediated Rejection, Kidney transplant outcomes, Long-term survival, AMR
Received: 22 Aug 2025; Accepted: 30 Oct 2025.
Copyright: © 2025 Obeid, BROERING, Almeshari, Shah, Aleid, Almanea, Alabassi, Almozain, Marquez, Alsaadi and Ali. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tariq Z Ali, ali99@kfshrc.edu.sa
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