Scurt FG, et al. - In this systematic review and meta-analysis, researchers examined outcome differences following ABO-incompatible renal transplantation (ABOi-rTx) and ABO-compatible renal transplantation (ABOc-rTx). They included 40 studies with 49 patient groups and 65,063 patients who were eligible for analysis; 7,098 of these had undergone ABOi-rTx. Even with advancement in desensitization protocols and optimization of ABOi-rTx procedures, in the first three years following transplantation, excess mortality and loss of kidney grafts were found vs ABOc-rTx. ABOi-rTx was associated with significantly higher 1-year mortality, 3 years, and 5 years following transplantation vs ABOc-rTx. Death-censored graft survival was lower with ABOi-rTx vs ABOc-rTx at 1 year and 3 years only, but graft losses were comparable to that of ABOc-rTx after 5 years and patient survival after 8 years.