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At the time of transplant, both the graft and recipient types were ABO incompatible. Moreover, the donors had significantly higher levels of cholesterol than the recipients (271 ± 66 vs. 150 ± 50 mg/dl). ABO is significantly associated with serum cholesterol level \[[@b5]\]. A recent randomized trial demonstrated that ABO-incompatible living kidney transplantation could be performed safely and with a good graft function at 1 and 3 months \[[@b6]\]. However, the optimal time for ABO-incompatible transplantation remains unclear.
In conclusion, despite the infrequent occurrence of ESRD that requires RRT in patients without complicating factors, careful patient selection and thorough pre- and post-operative management are required. ABO-incompatible kidney transplantation is a viable option for some patients.
*Disclosure*: The authors declare no conflict of interest.