Abstract：
Kidney transplantation is considered an ideal treatment for end-stage renal disease (ESRD) because it provides a longer and better quality of life than dialysis. ABO-incompatible (ABO-I) kidney transplantation relies on two principles: (i) removal of antibodies from a blood group; and (ii) inhibition of reappearance of blood group antibodies by intensifying the induction and maintenance of immunosuppression. This systematic review aimed to analyze the success and safety of ABO-I live-donor kidney transplantation.
Databases, including Google Scholar, PubMed, Embase, Web of Science, and Medline were searched. Search duration was from the database establishment to December 2022. A thorough search was performed for relevant studies investigating the success and safety of ABO-I live-donor kidney transplantation. Two investigators independently extracted literature information and assessed the quality of the included studies. Heterogeneity test was performed using Cochrane\'s Q and chi-squared tests. All statistical analyses were performed using R software (version 4.2.1).
The search for relevant literature in the five electronic databases yielded 1238 articles. Of the 1238 articles, only 15 were included. Meta-analysis of outcomes from five studies showed a survival rate of 0.93 (95% confidence interval [CI]: 0.88 to 0.97, P < 0.001) after ≥3 years, while outcomes from 12 studies revealed a short-term patient survival rate of 0.94 (95% CI: 0.92 to 0.96, P = 0.75). In contrast, long- and short-term graft survival rates were 0.89 (95% CI: 0.75 to 0.96, P < 0.001) and 0.94 (95% CI: 0.90 to 0.97, P < 0.001), respectively. Incidence rates of infectious, surgical, and medical complications were 0.31 (95% CI: 0.22 to 0.41, P < 0.001), 0.12 (95% CI: 0.05 to 0.25, P < 0.001), and 0.38 (95% CI: 0.17 to 0.66, P < 0.001), respectively.
Good long- and short-term patient outcomes and graft survival rates were observed after ABO-I kidney transplantation. Similarly, the safety of performing kidney transplantations from living donors with ABO-I blood groups was established by the results of the current meta-analysis. Therefore, ABO-I live-donor kidney transplantations should be encouraged to reduce the time recipients spend on waiting lists and supplement the existing paired-exchange donor program.
Databases, including Google Scholar, PubMed, Embase, Web of Science, and Medline were searched. Search duration was from the database establishment to December 2022. A thorough search was performed for relevant studies investigating the success and safety of ABO-I live-donor kidney transplantation. Two investigators independently extracted literature information and assessed the quality of the included studies. Heterogeneity test was performed using Cochrane\'s Q and chi-squared tests. All statistical analyses were performed using R software (version 4.2.1).
The search for relevant literature in the five electronic databases yielded 1238 articles. Of the 1238 articles, only 15 were included. Meta-analysis of outcomes from five studies showed a survival rate of 0.93 (95% confidence interval [CI]: 0.88 to 0.97, P < 0.001) after ≥3 years, while outcomes from 12 studies revealed a short-term patient survival rate of 0.94 (95% CI: 0.92 to 0.96, P = 0.75). In contrast, long- and short-term graft survival rates were 0.89 (95% CI: 0.75 to 0.96, P < 0.001) and 0.94 (95% CI: 0.90 to 0.97, P < 0.001), respectively. Incidence rates of infectious, surgical, and medical complications were 0.31 (95% CI: 0.22 to 0.41, P < 0.001), 0.12 (95% CI: 0.05 to 0.25, P < 0.001), and 0.38 (95% CI: 0.17 to 0.66, P < 0.001), respectively.
Good long- and short-term patient outcomes and graft survival rates were observed after ABO-I kidney transplantation. Similarly, the safety of performing kidney transplantations from living donors with ABO-I blood groups was established by the results of the current meta-analysis. Therefore, ABO-I live-donor kidney transplantations should be encouraged to reduce the time recipients spend on waiting lists and supplement the existing paired-exchange donor program.
摘要：
背景：肾移植被认为是治疗终末期肾病（ESRD）的理想方法，因为它比透析提供了更长，更好的生活质量。ABO不相容(ABO-I)肾移植依赖于两个原则:(i)从血型中去除抗体;和(ii)通过加强免疫抑制的诱导和维持来抑制血型抗体的再现。本系统综述旨在分析ABO-I活体肾移植的成功和安全性。
方法：数据库，包括谷歌学者，PubMed,Embase,WebofScience,和Medline被搜查。搜索时间从数据库建立到2022年12月。对相关研究进行了彻底搜索，以调查ABO-I活体肾移植的成功和安全性。两名研究者独立提取文献信息并评估纳入研究的质量。使用Cochrane的Q和卡方检验进行异质性检验。使用R软件(4.2.1版)进行所有统计分析。
结果：在五个电子数据库中搜索相关文献，得出1238篇文章。在1238篇文章中，仅包括15个。5项研究结果的荟萃分析表明，≥3年后的生存率为0.93（95％置信区间[CI]：0.88至0.97，P<0.001）。而来自12项研究的结果显示患者的短期生存率为0.94（95％CI：0.92至0.96，P=0.75）。相比之下,长短期移植物存活率分别为0.89(95%CI:0.75~0.96,P<0.001)和0.94(95%CI:0.90~0.97,P<0.001),分别。传染病的发病率，外科,内科并发症为0.31(95%CI:0.22~0.41,P<0.001),0.12（95%CI：0.05至0.25，P<0.001），和0.38（95%CI：0.17至0.66，P<0.001），分别。
结论：在ABO-I肾移植后观察到良好的长期和短期患者预后和移植物存活率。同样，根据目前的荟萃分析结果,确定了使用ABO-I血型的活体供者进行肾移植的安全性.因此,应鼓励ABO-I活体肾移植，以减少接受者在等待名单上花费的时间，并补充现有的配对交换供体计划。
方法：数据库，包括谷歌学者，PubMed,Embase,WebofScience,和Medline被搜查。搜索时间从数据库建立到2022年12月。对相关研究进行了彻底搜索，以调查ABO-I活体肾移植的成功和安全性。两名研究者独立提取文献信息并评估纳入研究的质量。使用Cochrane的Q和卡方检验进行异质性检验。使用R软件(4.2.1版)进行所有统计分析。
结果：在五个电子数据库中搜索相关文献，得出1238篇文章。在1238篇文章中，仅包括15个。5项研究结果的荟萃分析表明，≥3年后的生存率为0.93（95％置信区间[CI]：0.88至0.97，P<0.001）。而来自12项研究的结果显示患者的短期生存率为0.94（95％CI：0.92至0.96，P=0.75）。相比之下,长短期移植物存活率分别为0.89(95%CI:0.75~0.96,P<0.001)和0.94(95%CI:0.90~0.97,P<0.001),分别。传染病的发病率，外科,内科并发症为0.31(95%CI:0.22~0.41,P<0.001),0.12（95%CI：0.05至0.25，P<0.001），和0.38（95%CI：0.17至0.66，P<0.001），分别。
结论：在ABO-I肾移植后观察到良好的长期和短期患者预后和移植物存活率。同样，根据目前的荟萃分析结果,确定了使用ABO-I血型的活体供者进行肾移植的安全性.因此,应鼓励ABO-I活体肾移植，以减少接受者在等待名单上花费的时间，并补充现有的配对交换供体计划。
