RETROSPECTIVE AND PROSPECTIVE STUDIES ON THE EFFECT OF BLOOD TRANSFUSIONS IN RENAL TRANSPLANTATION IN THE NETHERLANDS

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Abstract
The effect of blood transfusion on cadaveric kidney graft survival was studied retrospectively in 103 Dutch recipients. Seventy-four patients who had never been transfused or pregnant before transplantation had a 1-year graft survival of 32%, whereas 30 patients with only one transfusion had a very superior graft survival of 87% after 1 year (X2 = 22.85 P < 0.00001). Nineteen patients who received prospectively 1 unit of leucocyte-poor blood before transplantation had a 79% graft survival after 240 days. This is not statistically different from the results in the retrospective group with one transfusion. Patients who received prospectively 1 or 3 units leucocyte-free blood before transplantation had a 25% graft survival after 240 days. This does not differ from the graft survival in the never-transfused retrospective group (X2 = 0.31, P = 0.57). HLA matching between kidney donor and recipient could not explain the difference between the two prospectively transfused groups. For both groups the average number of HLA mismatches was equal, namely, 1.7. The average number of HLA mismatches between blood transfusion donors and kidney recipients also did not play a role of importance in both prospectively transfused groups. Even repeated mismatches on the blood transfusion donor as on the kidney donor did not give a worse graft outcome. There was no clear-cut correlation between kidney graft survival and the time of transfusion in the retro- as well as in the prospective groups. The fact that the mean hemodialysis period was longer in the leucocyte-poor prospectively transfused group than in the leucocyte-free transfused group could not explain the better graft survival in the first group, as they received only one transfusion. Finally, there was no beneficial effect seen of peroperative blood transfusions on kidney graft prognosis.