Influence of pre- and perioperative blood transfusions on renal allograft survival.

One hundred and seventy-nine patients who received transplants between January 1975 and May 1980 have been studied retrospectively in order to elucidate the effect of pre- and perioperative random third-party blood transfusions on first cadaveric renal allograft survival. The 179 patients were approximately evenly divided into four groups; those who received blood transfusions preoperatively only (group 1, n = 45), received blood both pre- and perioperatively (group 2, n = 48), received blood perioperatively only (group 3, n = 37), or were never transfused before transplantation or perioperatively (group 4, n = 49). Actuarial graft survival for group 1 was 73% at 1 to 4 years, which was significantly better (P less than or equal to 0.02) than each of the other three groups at all four intervals. Groups 2, 3, and 4 were statistically identical to each other and had graft survivals of 52% or less at 1 to 4 years. From our study we conclude that: (1) Preoperative transfusions confer significant benefit on recipients of first cadaveric renal allografts. (2) Perioperative blood transfusions are without significant benefit in previously untransfused patients, and significantly lower allograft survival in previously transfused patients. A rational blood transfusion policy based on these results would be to transfuse renal allograft recipients preoperatively and avoid perioperative blood transfusions as much as possible.