O'Brien Frank J, Lineen James, Kennedy Claire M, Phelan Paul J, Kelly Patrick O, Denton Mark D, Magee Colm, Conlon Peter J
Department of Nephrology, Beaumont Hospital, Dublin, Ireland.
Clin Nephrol. 2012 Jun;77(6):432-7. doi: 10.5414/cn107436.
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.
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.
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.
Perioperative blood transfusion is associated with reduced long-term graft survival.
已证实输血会促进对人类白细胞抗原（HLA）抗原的致敏，增加等待移植的时间，并可能导致更高的排斥率。关于围手术期输血如何影响患者和移植物结局，人们了解较少。本研究旨在确定围手术期输血与移植物或患者生存率之间是否存在关联。
这是一项单中心、全国性的回顾性队列研究。收集了14年间接受肾移植患者的数据（n = 2013）。主要结局是围手术期接受输血的患者与未接受输血的患者的移植物生存率和死亡率。
与未接受输血的患者相比，接受输血的患者血红蛋白水平较低，更可能为男性，移植肾功能延迟的发生率更高。输血患者的一年移植物生存率为83%，未输血患者为94%（p = < 0.0001）。对混杂因素进行调整后显示，接受输血仍与移植物丢失增加相关。输血前的血红蛋白水平对移植物结局没有影响。
围手术期输血与长期移植物生存率降低相关。
