When a family member steps forward to donate a kidney to a loved one suffering from end-stage renal disease, a blood type mismatch used to mean the transplant was impossible—or that the patient had to travel to a major tertiary hospital in Seoul.
Today, that is no longer the case. Through an "ABO-incompatible kidney transplant," clinicians lower a recipient's antibody levels and regulate their immune responses, enabling successful organ transplants across incompatible blood groups..
As of June 30, 2026, Bongsaeng Memorial Hospital in Busan has completed 167 ABO-incompatible kidney transplants, the highest total in the Busan-Ulsan-South Gyeongsang region. Despite its classification as a secondary comprehensive general hospital, Bongsaeng has performed more of these complex procedures than many regional tertiary general hospitals or university medical centers.
Managing High-Complexity Transplants Across Mismatched Blood Types
An ABO-incompatible transplant extends far beyond surgical extraction and implantation. Because the recipient's pre-existing antibodies can attack the newly grafted organ, medical teams must reduce antibody levels prior to surgery and closely monitor for both organ rejection and opportunistic infections afterward.
This requires tight coordination among nephrology, transplant surgery, anesthesiology, laboratory medicine, and the dialysis unit. If immunosuppressive medications are administered too sparingly, the risk of organ rejection rises; if used excessively, the patient becomes highly vulnerable to infection.
Reaching 167 successful cases underscores not just surgical skill, but Bongsaeng Memorial Hospital’s ability to repeatedly execute every phase of immune management—from patient selection and preoperative conditioning to long-term follow-up care.
Since launching its kidney transplant program in 1995, Bongsaeng has performed a cumulative 1,452 transplants as of June 30, 2026. This includes 1,126 living-donor procedures (which encompass ABO-incompatible transplants) and 326 deceased-donor procedures.
"Kidney transplantation is not a field where a single talented surgeon can succeed alone," explained Kim Jung-kyung, honorary director of nephrology at Bongsaeng Memorial Hospital. He emphasized that long-term success relies on sustained teamwork across nephrology, surgery, dialysis, laboratory medicine, and dedicated transplant coordinators. Maintaining a stable medical team whose members share years of clinical experience is the hospital’s core asset.
Long-Term Patient and Graft Survival Outcomes
Care for transplant recipients extends long past the operating room. Patients must maintain lifelong immunosuppressive therapy while remaining vigilant for signs of rejection or infection, such as fever, decreased urine output, or swelling. Managing underlying conditions like hypertension and diabetes—the primary causes of kidney failure—is equally critical.
Bongsaeng Memorial Hospital’s 30-year track record (1995–2025) reflects this rigorous follow-up model. Patient survival rates stand at 98.5% at 1 year, 97.0% at 5 years, and 95.3% at 10 years, with more than 95% of recipients surviving past a decade. The 20-year patient survival rate remains remarkably high at 86.6%.
Graft survival—the proportion of transplanted kidneys that continue to function without requiring a return to dialysis—further demonstrates the quality of care. Bongsaeng reported graft survival rates of 97.6% at 1 year, 92.6% at 5 years, and 84.2% at 10 years.
Time after transplant | Patient survival rate | Graft survival rate |
1 year | 98.5% | 97.6% |
5 years | 97.0% | 92.6% |
10 years | 95.3% | 84.2% |
20 years | 86.6% | 60.4% |
Dedicated Postoperative Coordination
When patients have urgent questions regarding lab results or medication adjustments, rapid communication is vital. Bongsaeng Memorial Hospital utilizes dedicated coordinators who contact patients directly via phone or text message as soon as lab findings are ready.
Even for patients living in other regions, coordinators act as the primary point of contact, evaluating symptoms and advising whether home monitoring, dosage adjustments, or an immediate hospital visit is necessary.
"Transplant patients must be able to reach us immediately whenever an issue arises," Kim noted. "We maintain direct, real-time lines of communication, which is especially reassuring for elderly patients."
Frequently Asked Questions: ABO-Incompatible Kidney Transplants
Is a kidney transplant impossible if blood types do not match?
No. Many patients can safely undergo an ABO-incompatible transplant after evaluating antibody levels and receiving specialized conditioning to lower antibody counts prior to surgery.
Must a kidney transplant be performed at a university hospital?
Not necessarily. Factors such as cumulative transplant volume, multidisciplinary collaboration, emergency dialysis capacity, and long-term post-operative care are far more critical. Select secondary general hospitals match or exceed university medical centers in these core capabilities.
Does medical care end after a successful transplant?
No. Patients must take immunosuppressive medications continuously and undergo routine monitoring for rejection, infection, drug side effects, and overall graft function to ensure long-term survival.
Expert Input: Kim Jung-kyung, Honorary Director of Nephrology at Bongsaeng Memorial Hospital. A graduate of Yonsei University Wonju College of Medicine, Kim completed a clinical fellowship at the University of Colorado Hospital Kidney Transplant Center in the United States. He has been an active member of the Korean Society of Nephrology, the Korean Society for Transplantation, and the American Society of Nephrology. He co-authored "Clinical Guidelines for Kidney Transplantation" and "Kidney Transplantation in Sensitized Patients," and authored the patient guide "Living With a New Kidney."
