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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Kidney transplantation in India faces challenges of donor-recipient incompatibility, leading to underutilization of potential living donors. Two key innovations—ABO-incompatible (ABOi) and kidney paired donation (KPD or swap)—have expanded access, yet large-scale comparative outcome data from developing nations are scarce. This multicenter study aims to compare clinical outcomes of ABOi, KPD, and ABO-compatible (ABOc) kidney transplantation in India using real-world data from high-volume centers.
This retrospective multicenter cohort study included 37,702 living donor kidney transplants performed across 25 tertiary transplant centers in India (2013–2023). Data were retrieved from institutional transplant registries and verified through ethics approval by the IKDRC-GUTS Ethics Committee. Patients were categorized into three cohorts: ABOi (n=2,972), KPD (n=1,291), and ABOc (n=33,439). Outcomes analyzed included patient survival, graft survival, biopsy-proven acute rejection (BPAR), and hospitalisation-requiring infections at 1 year. Demographic and clinical parameters were compared using chi-square and Kaplan-Meier analyses.
Recipient and donor demographics were comparable across all cohorts (Recipient M:F = 3:2; Donor M:F = 2:3). At one year, mean serum creatinine was similar among ABOi, KPD, and ABOc recipients, indicating comparable graft function. One-year BPAR rates did not differ significantly across groups (p=1.5×10⁻¹⁴), and infection-related hospitalisations were also comparable (p=1.3×10⁻²¹). Patient survival at one, three, and five years remained excellent across all modalities, with no clinically significant difference between ABOi and ABOc (p=0.004). Similarly, graft survival showed parity between ABOi and KPD groups (p=0.31), establishing equivalent short-term outcomes. Despite a higher baseline immunologic risk in ABOi transplants, outcomes were comparable, underscoring improved desensitisation and immunosuppression protocols across participating centers. This study represents the largest real-world comparative dataset of ABOi, KPD, and conventional transplants globally, demonstrating India’s maturing expertise in alternative living donor strategies.
Outcomes of ABO-incompatible and KPD kidney transplantation are comparable to conventional ABO-compatible transplants in the Indian setting. Rates of rejection, infection, and survival were similar across groups despite differing immunologic barriers. These findings affirm that innovative strategies such as ABOi and KPD are safe and effective options to overcome biological incompatibility and expand the donor pool. The large-scale, multicenter evidence reinforces the feasibility of advanced immunological and paired-exchange programs in low- and middle-income countries. Further prospective and long-term follow-up studies are warranted to evaluate chronic outcomes and cost-effectiveness.
