DOMINANT EFFECT OF TRANSFUSIONS ON KIDNEY GRAFT SURVIVAL

Abstract

The number of pretransplant blood transfusions influences the graft survival of cadaver kidney transplants more than HLA-A and B matching, preformed lymphocytotoxic antibodies, or center variation. At 1 yr the graft survival rate in patients with more than 30 packed cells transfusions was over 30% higher than that in nontransfused recipients (75 .+-. 5% vs. 41 .+-. 2%, P < 0.0001). Recipients with 1 packed cell transfusion had a 59 .+-. 5% 1 yr graft survival rate. Frozen blood and any transfusions given at the time of surgery were relatively ineffective. Pretransplant pregnancies had no significant effect on graft outcome. The improvement effect of transfusions was significan in each of the last 4 calendar years (1975, P < 0.001; 1976, P < 0.01; 1977, P < 0.0001; 1978, P < 0.0001). The percentage of nontransfused recipients has remained almost unchanged over the years. A preliminary survey of transplants done from Jan. to April 2979 showed that 1/3 of the recipients had not been transfused. A change in transfusion policy is indicated to improve the results of cadaver kidney transplantation.