Is peri-transplant blood transfusion associated with worse transplant outcomes? A retrospective study

Abstract

BACKGROUND Blood transfusion is common during the peri-transplantation period. The incidence of immunological reactions to blood transfusion after kidney tran splantation and their consequences on graft outcomes have not been extensively studied. AIM To examine the risk of graft rejection and loss in patients who received blood transfusion in the immediate peri-transplantation period. METHODS We conducted a single-center retrospective cohort study of 105 kidney recipients, among them 54 patients received leukodepleted blood transfusion at our center between January 2017 and March 2020. RESULTS This study included 105 kidney recipients, of which 80% kidneys were from living-related donors, 14% from living-unrelated donors, and 6% from deceased donors. Living-related donors were mostly first-degree relatives (74.5%), while the rest were second-degree relatives. The patients were divided into transfusion ( n = 54) and non-transfusion ( n = 51) groups. The average hemoglobin level at which blood transfusion was commenced was 7.4 ± 0.9 mg/dL. There were no differences between the groups in terms of rejection rates, graft loss, or death. During the study period, there was no significant difference in creatinine level progression between the two groups. Delayed graft function was higher in the transfusion group; however, this finding was not statistically significant. A high number of transfused packed red blood cells was significantly associated with increased creatinine levels at the end of the study. CONCLUSION Leukodepleted blood transfusion was not associated with a higher risk of rejection, graft loss, or death in kidney transplant recipients.

Abdominal Organ Transplantation: Noteworthy Literature in 2023

“…However, the authors demonstrated a non-significant increase in delayed graft function and a significant increase in serum creatinine at the conclusion of the study in the transfusion group. 36 Interestingly, a large retrospective study of 12,559 kidney transplant recipients in 2 prospective nationwide French registries found that storage of packed RBCs longer than 20 days prior to transfusion was associated with decreased rates of transplant failure [hazard ratio (HR): .84, 95% CI: .73–.96 for each additional day]. Patients who received packed RBCs stored for greater than 20 days had a 2.1% increase in transplant survival at 1 year and 6% at 5 years compared to those who received units with shorter storage duration.…”

Nierentransplantierte in der Notaufnahme: Allgemeines und Komplikationen

“…Darüber hinaus ist allerdings eher Zurückhaltung angezeigt[34]. Letztlich sind die Auswirkungen dieser Transfusionen nach Transplantation und ihre möglichen Effekte auf das Transplantat nicht abschließend untersucht; die Immunisierungsgefahr ist mit der Einführung Leukozyten-depletierter Erythrozytenkonzentrate jedoch gesunken[35,36,37,38]. Ebenfalls ist das Risiko einer primären CMV-Infektion durch die Transfusion von Leukozytendepletierten Blutprodukten niedrig.…”