Prospective evaluation of pretransplant blood transfusions in cadaver kidney recipients
Opelz, G × Vanrenterghem, Yves Kirste, G Gray, D W Horsburgh, T Lachance, J G Largiader, F Lange, H Vujaklija-Stipanovic, K Alvarez-Grande, J Schott, W Hoyer, J Schnuelle, P Descoeudres, C Ruder, H Wujciak, T Schwarz, V #
Transplantation vol:63 issue:7 pages:964-7
BACKGROUND: A beneficial effect of pretransplant transfusions on graft survival was demonstrated in the early 1970s. In the mid-1980s, however, retrospective studies showed that transfusions had lost their graft-protective effect in the cyclosporine era. During the last 10 years, deliberate transfusion pretreatment of transplant patients has been discontinued. METHODS: Within a collaborative project of 14 transplant centers, prospective recipients of cadaver kidney grafts were randomized to receive either three pretransplant transfusions or transplants without transfusions. RESULTS; The graft survival rate was significantly higher in the 205 transfusion recipients than in the 218 patients who did not receive transfusions (at 1 year: 90+/-2% vs. 82+/-3%, P=0.020; at 5 years: 79+/-3% vs. 70+/-4%, P=0.025). Cox regression analysis showed that this effect was independent of age, gender, underlying disease, prophylaxis with antilymphocyte antibodies, and preformed lymphocytotoxins. CONCLUSIONS; Transfusion pretreatment improves the outcome of cadaver kidney transplants even with the use of modern immunosuppressive regimens.