Prospective evaluation of pretransplant blood transfusions in cadaver kidney recipients.
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.
Opelz
G
G
Department of Transplantation Immunology, University of Heidelberg, Germany.
Vanrenterghem
Y
Y
Kirste
G
G
Gray
D W
DW
Horsburgh
T
T
Lachance
J G
JG
Largiader
F
F
Lange
H
H
Vujaklija-Stipanovic
K
K
Alvarez-Grande
J
J
Schott
W
W
Hoyer
J
J
Schnuelle
P
P
Descoeudres
C
C
Ruder
H
H
Wujciak
T
T
Schwarz
V
V
D001803:Blood Transfusion / Q000706:statistics & numerical data; D002102:Cadaver; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors