Transfusion and renal allograft survival: beneficial effect of transfusions given on day of transplantation.

To determine if the beneficial effect of blood transfusion on renal allograft survival can be obtained without risk of presensitization, we examined the effect of transfusions given on the day of transplant surgery in a series of 180 primary cadaveric renal allografts. Three-month graft survival of those transfused only on the day of transplant was significantly better than the graft survival of those never transfused, and was not significantly different from graft survival of those transfused during the dialysis waiting period. Maximal beneficial effect was achieved by administration of as few as two to three units. We conclude that the benefits of transfusion can be obtained while minimizing the risks of presensitization if transfusion is minimized during the dialysis waiting period and patients are electively transfused at the time of transplant.