Effect of pre-transplant blood transfusions and haemodialysis on the survival of first kidney grafts from living related donors.

The influence of pre-transplant blood transfusions and haemodialysis has been analyzed in 191 consecutive living related first transplants. A significantly increased graft survival was seen among patients having received blood transfusions and transplanted with a 1 haplotype disparate kidney, while no effect could be observed in HLA-identical transplantations. No significant effect could be detected on recipient survival. Four patients to receive 1 haplotype mis-matched grafts were sensitized against their potential donors by transfusions, and therefore not transplanted with living related donors. The frequency of first rejection episodes was highly significantly reduced in transfused compared to non-transfused 1 haplotype mis-matched transplanted patients while no influence was seen in identicals. Pretransplant haemodialysis improved graft survival, the difference was, however, only significant in the 1 haplotype mis-matched group. When analyzed for patient survival, the difference between the pre-dialytic patients and those on haemodialysis was even more pronounced. When analyzed separately, both blood transfusions and haemodialysis had a beneficial effect on graft survival.