Effect of perioperative blood transfusions on long term graft outcomes in renal transplant patients

O'Brien, Frank; Lineen, James; Kennedy, Claire; Phelan, Paul J.; Kelly, P; Denton, Mark D.; Magee, Colm; Conlon, Peter J.

doi:10.5414/cn107436

Cited by 20 publications

(11 citation statements)

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“…In our cohort, older age and DGF were associated with higher risk of death. Sensitization was irrelevant, as with most of other studies except for very few . LS group defined by pPRA did show higher risk of death.…”

Section: Discussionmentioning

confidence: 70%

Pretransplant virtual PRA and long-term outcomes of kidney transplant recipients

et al. 2015

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SummaryVirtual panel-reactive antibodies (vPRA) have been implemented to gauge sensitization worldwide. It is unclear how it associates with long-term outcomes, and its correlation with peak (pPRA) or actual (aPRA) has not been studied. We retrospectively reviewed data from 18-to 65-year-old kidney-only transplant patients during 1.1.1996-31.7.2011 in our center. PRAs were calculated based on solidphase techniques. Of the 726 qualified cases, regardless of the PRA type, sensitized patients (PRA > 5%) had more females and previous transplant. Highly sensitized (HS, PRA > 50%) had longer waiting time, lower transplant rate, less living donor, more delayed graft function, and acute rejection. The conformity between vPRA and pPRA in HS was 75%, 57% between pPRA and aPRA. Forty-three percent (61/142) patients whose pPRA was >5% had no detectable aPRA and maintained similar outcomes as sensitized patients. Multivariate analysis showed consistently lower death-censored graft survival in HS defined by vPRA [HR 2.086 (95% CI 1.078-4.037), P < 0.05] and pPRA [HR 2.139 (95% CI 1.024-4.487), P < 0.05]. Both vPRA and pPRA provided reliable way estimating sensitization and predicting long-term graft survival, while aPRA might underestimate true sensitization. vPRA might be the most objective parameter to gauge sensitization.

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Section: Discussionmentioning

confidence: 70%

Pretransplant virtual PRA and long-term outcomes of kidney transplant recipients

et al. 2015

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“…These factors are consistent with those reported in the literature: increased risk of transfusion in renal transplant has previously been linked to warfarin/antiplatelet agents, older age, lower preoperative Hb, autosomal polycystic kidney disease, and duration of hospital stay. 1,3,10,15,16 Interestingly, we found that female gender was significantly associated with blood transfusion within our cohort. This has been inconclusively demonstrated in the literature with retrospective studies demonstrating effects in both directions.…”

Section: Discussionmentioning

confidence: 51%

Assessing the Necessity of Routine Crossmatching for Blood Transfusion in Renal Transplantation

et al. 2020

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Introduction: Routine crossmatch of packed red blood cells (pRBCs) is completed preoperatively at many centers despite conflicting evidence on the incidence of blood transfusions with renal transplantation. In the current economic climate, resource adjudication should be judicious and medically appropriate. The objective of this study was to determine the incidence, timing, and predictors of early postoperative pRBC transfusion in patients undergoing renal transplantation. Methods: A retrospective review of all patients undergoing renal transplantation at our institution from January 2013 to May 2016 was performed. Demographic, biochemical, and clinical parameters were recorded. The primary outcome was early postoperative transfusion, defined as an intraoperative transfusion or within 2 days of surgery. Multivariable logistic regression was performed to identify associations with early postoperative transfusion. Results: We identified 428 patients during the study period (average age 55 years, 60% male, 30% obese, 67% deceased donor, and 43% preoperative antithrombotic use). Forty (9.3%) patients required early postoperative transfusion (mean: 2.8 pRBCs/transfusion) and most did not require blood urgently. Only 20 (4.7%) patients required a transfusion intraoperatively or on the same day of surgery. Lower preoperative hemoglobin (per g/L unit: odds ratio [OR]: 0.943), female gender (OR: 2.752), and preoperative antithrombotic use (OR 2.369) were associated with a need for early postoperative transfusion. Conclusion: Transfusion in the early postoperative period following renal transplantation was less than 10%, suggesting that routine crossmatch may not be necessary for all patients. Preoperative hemoglobin, female gender, and preoperative antithrombotic use were associated with increased risk and may be useful to risk-stratify patients who require crossmatch.

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“…Mainra et al [7] described the case of an acute humoral kidney rejection in a previously non-sensitized female patient after IVIG administration. Some reports indicate a negative correlation of a graft rejection with preoperative transfusions [23], whereas others show a lack of impact [24,25] or deterioration of graft survival after preoperative transfusions [26]. Due to the multiple pathways of immune modulation effects, IVIGs are used in desensitization procedures and humoral rejection episodes.…”

Section: Discussionmentioning

confidence: 99%

Anti–Human Leukocyte Antigen Antibodies Are Present in Blood of Blood Donors: Is Therapy With Blood Preparations Safe for Graft Recipients?

Nowosiad-Magda

Myślak

Roszkowska

et al. 2014

Transplantation Proceedings

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Effect of perioperative blood transfusions on long term graft outcomes in renal transplant patients

Cited by 20 publications

References 0 publications

Pretransplant virtual PRA and long-term outcomes of kidney transplant recipients

Pretransplant virtual PRA and long-term outcomes of kidney transplant recipients

Assessing the Necessity of Routine Crossmatching for Blood Transfusion in Renal Transplantation

Anti–Human Leukocyte Antigen Antibodies Are Present in Blood of Blood Donors: Is Therapy With Blood Preparations Safe for Graft Recipients?

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