Interrelationship of time of dialysis-dependent uremia and pretransplant blood transfusions.

In a consecutive series of 167 renal allotransplants, a statistically significant correlation was found between the number of pretransplant blood transfusions and the time of dialysis-dependent uremia. This correlation suggests that one possible explanation for the association of a beneficial effect of pretransplant blood transfusions with allograft survival may be in part due to the prolongation of uremia, which is a well-known immunosupressive factor. This begs the question of whether the transfusion-dialysis time association promotes a further selection factor leaving sensitized patients waiting for longer periods of time for transplants or unable to receive transplants at all. Whether the transfusion and the favorable prognosis association is also related to other specific immunological mechanisms remains to be proven.