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

BACKGROUND

It is established that blood transfusions will promote sensitization to human leucocyte antigen (HLA) antigens, increase time spent waiting for transplantation and may lead to higher rates of rejection. Less is known about how perioperative blood transfusion influence patient and graft outcome. This study aims to establish if there is an association between perioperative blood transfusion and graft or patient survival.

MATERIALS AND METHODS

This was a single center, national, retrospective cohort study. Data was collected on patients who received kidney transplants over a 14-year period (n = 2,013). The primary outcomes were graft survival and mortality in patients who received blood transfusions in the perioperative period compared to those who did not.

RESULTS

Patients who received blood transfusions had lower hemoglobin levels, were more likely to be male, and had higher rates of delayed graft function compared to those who did not receive a transfusion. The one year graft survival of those transfused was 83% compared to 94% in those not transfused (p = < 0.0001). Adjustment for confounding showed that the receipt of a blood transfusion remained associated with increased graft loss. Hemoglobin levels prior to transfusion did not have an influence on graft outcome.

CONCLUSION

Perioperative blood transfusion is associated with reduced long-term graft survival.