title: Pre-kidney-transplant blood transfusions do not improve transplantation outcome: a Dutch national study.
abstract: BACKGROUND
  Female renal transplant candidates are prone to be sensitized by prior pregnancies, and undetected historical sensitization might decrease transplantation outcome. Hypothesis of our study was that pre-transplant blood transfusions (PTFs) can elucidate historical sensitization and that the avoidance of the associated antigens can improve transplantation outcome.
  
  
  METHODS
  Data from all female non-immunized renal transplant candidates who received a random PTF (rPTF) (n = 620), matched PTF (mPTF) (one HLA-A and B and one HLA-DR match) (n = 86) or donor-specific blood transfusion (DST) (n = 100) between 1996 and 2006 were collected. Complement-dependent cytoxicity was used to detect anti-HLA antibodies. Sensitization and transplantation outcomes after a PTF were analyzed. Non-immunized female renal transplant recipients who did not receive a PTF were used as the control group.
  
  
  RESULTS
  In 165 patients, anti-HLA antibodies (IgG) were detected after the PTF. Both historical and primary sensitizations were found. A DST induced donor-specific anti-HLA antibodies in 25% of the DST recipients. Our policy did not improve transplantation outcome in recipients of a kidney from a deceased donor (n = 368) or in recipients of a living donor [DST (n = 49) and mPTF (n = 66)].
  
  
  CONCLUSIONS
  A PTF did elucidate historical sensitization but induce primary sensitization as well. No beneficial effect of PTFs on transplantation outcome was found, and PTFs with the intention to detect historical sensitization are therefore not suggested.
authors.affiliation: Department of Nephrology, University Medical Center Radboud, Postbus 9101, 6500 HB Nijmegen, The Netherlands. j.aalten@nier.umcn.nl
authors.forename: Jeroen
authors.initials: J
authors.lastname: Aalten
authors.forename: Frederike J
authors.initials: FJ
authors.lastname: Bemelman
authors.forename: Ella M
authors.initials: EM
authors.lastname: van den Berg-Loonen
authors.forename: Frans H
authors.initials: FH
authors.lastname: Claas
authors.forename: Maarten H
authors.initials: MH
authors.lastname: Christiaans
authors.forename: Johan W
authors.initials: JW
authors.lastname: de Fijter
authors.forename: Bouke G
authors.initials: BG
authors.lastname: Hepkema
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Hené
authors.forename: Jaap J Homan
authors.initials: JJ
authors.lastname: van der Heide
authors.forename: Johannes P
authors.initials: JP
authors.lastname: van Hooff
authors.forename: Neubury M
authors.initials: NM
authors.lastname: Lardy
authors.forename: Simon P
authors.initials: SP
authors.lastname: Lems
authors.forename: Henderikus G
authors.initials: HG
authors.lastname: Otten
authors.forename: Willem
authors.initials: W
authors.lastname: Weimar
authors.forename: Wil A
authors.initials: WA
authors.lastname: Allebes
authors.forename: Andries J
authors.initials: AJ
authors.lastname: Hoitsma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens