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Waiting to buy it later will backfire when you are struck by the content wave
Repentance changes, balances, and adds a lot of things, so the sooner you can get used to them the better. It also doubles the amount of characters available in Afterbirth+.
Repentance builds off of and requires afterbirth and ab+ (and rebirth of course). Things from afterbirth are carried over to Repentance, however things from repentance cannot be brought over to Afterbirth. Going from Repentance to Afterbirth+ is essentially a downgrade.
In your example, if you were to kill Mega Satan as Isaac or another character available in afterbirth+, I believe you should be able to keep the item if you downgrade.
However, if you kill him as Bethany or some other repentance character, the item will most likely not transfer over.
I've personally never messed with downgrading versions though, so my educated guesses may not be accurate to what happens.
Also, there's a new Online Co-op feature coming (in about a year or so until official release) that will be Repentance only. Not sure if you care about it, but it's there.
Merry Christmas and Happy holidays!
Note that anything unlocked while downgrading will not be ported to your Repentance save once you install it back either. That's just not how the game manages its saves.
But if you just want OP runs for fun, the debug console is your friend, even on Repentance.
Still it would have been great to have AB+ and REP launch options.