Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysis

Q4 Medicine

Transplantation Reports Pub Date : 2025-07-03 DOI:10.1016/j.tpr.2025.100181

Patricia Viana , Maria Meritxell Roca Mora , Jorge Eduardo Persson , André Milani-Reis , Harold Cliff Sullivan , Idelberto Raul Badell , Juliano Riella

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引用次数: 0

Abstract

Background

Studies have shown that A2 kidney transplants for blood group B recipients offer comparable graft and patient survival rates to ABO-compatible transplants, potentially improving transplant access for B recipients. However, the adoption of this strategy has been controversial.

Methods

We conducted a Systematic-Review and Meta-Analysis, comparing non-A1to B versus B to B blood type in kidney transplant patients. MEDLINE, Embase, and Cochrane databases were searched for studies that met our inclusion criteria. We analyzed binary and continuous endpoints using odds ratios (OR) and mean difference (MD), respectively, with a 95% confidence interval (CI). P-value < 0.05 was considered statistically significant.

Results

We included five studies with 14,959 patients, of whom 2,121 (14.2%) were non-A1 to B blood. No statistically significant differences were found between the groups for patient survival (OR 1.08; 95% CI 0.95 to 1.22; p=0.6), graft survival (OR 1.1; 95% CI 0.99 to 1.23; p=0.96), eGRF (MD 7.8 mL/min/1.73m²; 95% CI -8.27 to 23.87 mL/min/1.73m²; p=1.0), antibody-mediated rejection (OR 1.51; 95% CI 0.43 to 5.28; p = 0.52), and T-cell-mediated rejection (OR 1.12; 95% CI 0.43 to 2.93; p = 0.81).

Conclusion

We found no significant differences in patient and graft survival between non-A1 to B and B to B kidney transplantation. This finding underscores the potential to expand the donor pool without compromising outcomes, which has a profound impact on reducing waiting times and improving equity in renal transplant access.

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改善少数民族A2到B肾移植的可及性：一项系统回顾和荟萃分析

研究表明，B血型受者的A2肾移植与abo相容移植相比具有相当的移植和患者存活率，可能改善B血型受者的移植可及性。然而，这一策略的采用一直存在争议。方法：我们进行了一项系统综述和荟萃分析，比较非a1血型与B血型与B血型的肾移植患者。检索MEDLINE、Embase和Cochrane数据库，寻找符合我们纳入标准的研究。我们分别使用优势比（OR）和平均差（MD）分析二元终点和连续终点，置信区间为95%。假定值& lt;0.05认为有统计学意义。结果我们纳入了5项研究，14959例患者，其中2121例（14.2%）为非a1 - B血。两组患者生存率差异无统计学意义(OR 1.08；95% CI 0.95 ~ 1.22；p=0.6)，移植物存活(OR 1.1；95% CI 0.99 ~ 1.23；p=0.96), eGRF (MD 7.8 mL/min/1.73m2；95% CI -8.27 ~ 23.87 mL/min/1.73m2；p=1.0)，抗体介导的排斥反应(OR 1.51；95% CI 0.43 ~ 5.28；p = 0.52)和t细胞介导的排斥反应(OR 1.12；95% CI 0.43 ~ 2.93；P = 0.81)。结论非a1到B肾移植与B到B肾移植在患者和移植物存活方面无显著差异。这一发现强调了在不影响结果的情况下扩大供体池的潜力，这对减少等待时间和提高肾移植获得的公平性具有深远的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation Reports Medicine-Transplantation

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

101 days

期刊介绍： To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI