{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T14:18:06Z","timestamp":1782483486832,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,3,17]],"date-time":"2016-03-17T00:00:00Z","timestamp":1458172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["234\u20102005\u2010370011C"],"award-info":[{"award-number":["234\u20102005\u2010370011C"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The new United Network for Organ Sharing (<jats:styled-content style=\"fixed-case\">UNOS<\/jats:styled-content>) kidney allocation system (<jats:styled-content style=\"fixed-case\">KAS<\/jats:styled-content>) incorporates A2 and A2B to B transplantation to reduce wait times for blood group B candidates. Few studies have employed multicenter data or comprehensively defined donor\u2010to\u2010recipient <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content> classification systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed <jats:styled-content style=\"fixed-case\">UNOS<\/jats:styled-content> data from 1987\u20132013 to evaluate the effect of A2 incompatible (A2i) kidney transplantation on graft and patient survival. Records of 314 056 adults (340 150 transplants) were classified as A2i (560 transplants in A2 to B or O, A2B to B) or compatible. Methods included Kaplan<jats:bold>\u2013<\/jats:bold>Meier survival and multivariable Cox proportional hazards regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Graft survival after A2i transplant (median = 116 months) did not differ (log\u2010rank p \u2265 0.101) from any compatible class (medians = 106\u2013119 months); there was no effect of A2i on patient survival (log\u2010rank p \u2265 0.286). After adjusting for age, race, donor type, pancreas, or previous kidney transplant, A2i was not associated with graft (p \u2265 0.263) or patient (p \u2265 0.060) survival in this largest cohort to date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A2i kidney transplantation does not adversely affect graft or patient survival. A2i kidney transplantation has been included in the new <jats:styled-content style=\"fixed-case\">KAS<\/jats:styled-content> and represents a viable option for transplant centers to increase transplant volume and reduce wait times for disadvantaged B waitlist recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.12724","type":"journal-article","created":{"date-parts":[[2016,2,26]],"date-time":"2016-02-26T03:16:48Z","timestamp":1456456608000},"page":"589-597","source":"Crossref","is-referenced-by-count":32,"title":["A2 incompatible kidney transplantation does not adversely affect graft or patient survival"],"prefix":"10.1111","volume":"30","author":[{"given":"Rachel C.","family":"Forbes","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Kidney and Pancreas Transplantation Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene D.","family":"Feurer","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Biostatistics Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Kidney and Pancreas Transplantation Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,3,17]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"http:\/\/optn.transplant.hrsa.gov\/converge\/latestData\/rptStrat.asp. Accessed January 16 2015."},{"key":"e_1_2_6_3_1","unstructured":"http:\/\/optn.transplant.hrsa.gov\/news\/revised-national-kidney-transplant-allocation-system-is-now-in-place. Accessed January 16 2015."},{"key":"e_1_2_6_4_1","first-page":"88","article-title":"The specific distribution of glycolipid\u2010based blood group A antigens in human kidney related to A1\/A2 Lewis, and secretor status of single indivdiuals. A possible molecular explanation for successful transplantation of A2 kidneys into O recipients","volume":"42","author":"Breimer ME","year":"1986","journal-title":"Transplantation"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-198802000-00013"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000231697.15817.51"},{"key":"e_1_2_6_7_1","first-page":"427","article-title":"Renal transplantation across a blood group barrier \u2018A2\u2019 kidneys to \u2018O\u2019 recipients","volume":"19","author":"Brynger H","year":"1983","journal-title":"Proc Eur Dial Transplant Assoc"},{"key":"e_1_2_6_8_1","first-page":"1175","article-title":"Experience with 14 renal transplants with kidneys from blood group A (subgroup A2) to O recipients","volume":"16","author":"Brynger H","year":"1984","journal-title":"Transplant Proc"},{"key":"e_1_2_6_9_1","first-page":"4528","article-title":"Blood group ABO\u2010incompatible (A2 to O) kidney transplantation in human subjects: a clinical, serologic, and biochemical approach","volume":"19","author":"Rydberg L","year":"1987","journal-title":"Transplant Proc"},{"key":"e_1_2_6_10_1","first-page":"4565","article-title":"Transplantation of blood group A2 kidneys into O or B recipients: the effect of pretransplant anti\u2010A titers on graft survival","volume":"19","author":"Welsh KI","year":"1987","journal-title":"Transplant Proc"},{"key":"e_1_2_6_11_1","first-page":"4562","article-title":"Experience of blood group A2 renal allografts in ABO\u2010incompatible recipients","volume":"19","author":"Shapira Z","year":"1987","journal-title":"Transplant Proc"},{"key":"e_1_2_6_12_1","first-page":"4538","article-title":"Present experiences in a series of 26 ABO\u2010incompatible donor renal allografts","volume":"19","author":"Alexandre GPJ","year":"1987","journal-title":"Transplant Proc"},{"key":"e_1_2_6_13_1","first-page":"4561","article-title":"Accelerated acute rejection in blood group O recipients of renal grafts from blood group A2 incompatible living donors","volume":"19","author":"Jakobsen A","year":"1987","journal-title":"Transplant Proc"},{"key":"e_1_2_6_14_1","first-page":"1738","article-title":"ABO incompatible transplant involving A2 donors","volume":"23","author":"Mendez R","year":"1991","journal-title":"Transplant Proc"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.2001.001003296.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.01750.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2005.00452.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181da191a"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2011.01543.x"},{"key":"e_1_2_6_20_1","unstructured":"http:\/\/optn.transplant.hrsa.gov\/SharedContentDocuments\/Guidance_OSC_ABO_Subtyping_06-2011.pdf. 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