Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysis
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...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-09-01
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| Series: | Transplantation Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451959625000113 |
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| author | Patricia Viana Maria Meritxell Roca Mora Jorge Eduardo Persson André Milani-Reis Harold Cliff Sullivan Idelberto Raul Badell Juliano Riella |
| author_facet | Patricia Viana Maria Meritxell Roca Mora Jorge Eduardo Persson André Milani-Reis Harold Cliff Sullivan Idelberto Raul Badell Juliano Riella |
| author_sort | Patricia Viana |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-4c2bdaf19f2c4eef90ecdd0d355cde6e |
| institution | DOAJ |
| issn | 2451-9596 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Transplantation Reports |
| spelling | doaj-art-4c2bdaf19f2c4eef90ecdd0d355cde6e2025-08-20T03:22:39ZengElsevierTransplantation Reports2451-95962025-09-0110310018110.1016/j.tpr.2025.100181Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysisPatricia Viana0Maria Meritxell Roca Mora1Jorge Eduardo Persson2André Milani-Reis3Harold Cliff Sullivan4Idelberto Raul Badell5Juliano Riella6Department of Medicine, University of Extreme South of Santa Catarina, Criciuma, Brazil; Corresponding author at: Av. Universitaria, 1105 – Criciuma, Santa Catarina 88806-000 Brazil.Department of Medicine, Univeristat Internacional de Catalunya, Barcelona, SpainDepartment of Medicine, University of Extreme South of Santa Catarina, Criciuma, BrazilDepartment of Medicine, University of Campinas, Campinas, BrazilDepartment of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, USADepartment of Surgery, Emory University School of Medicine, Atlanta, USADepartment of Surgery, Emory University School of Medicine, Atlanta, USABackground: 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.http://www.sciencedirect.com/science/article/pii/S2451959625000113KidneyTransplantNon-A1 donorMinoritiesOutcomes |
| spellingShingle | Patricia Viana Maria Meritxell Roca Mora Jorge Eduardo Persson André Milani-Reis Harold Cliff Sullivan Idelberto Raul Badell Juliano Riella Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysis Transplantation Reports Kidney Transplant Non-A1 donor Minorities Outcomes |
| title | Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysis |
| title_full | Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysis |
| title_fullStr | Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysis |
| title_full_unstemmed | Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysis |
| title_short | Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysis |
| title_sort | improving access to minorities with a2 to b kidney transplantation a systematic review and meta analysis |
| topic | Kidney Transplant Non-A1 donor Minorities Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2451959625000113 |
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