Allosensitization rate of male patients awaiting first kidney grafts after leuko-depleted blood transfusion.
BACKGROUND
Blood transfusions are generally avoided for potential renal transplant recipients due to risk of human leukocyte antigen (HLA) allosensitization. Despite the near universal use of erythropoiesis-stimulating agents, there are still occasions when patients require blood transfusions for reasons such as resistance to erythropoiesis-stimulating agents or cardiovascular instability. The risk of allosensitization in renal patients is believed to be lower with leuko-depleted blood. We sought to quantify the risk of blood transfusion per se in male renal patients on the transplant waiting list for their first kidney graft, using sensitive solid phase antibody detection.


METHODS
Cross-sectional survey looking at the prevalence of HLA antibody detected using single antigen Luminex beads in male patients awaiting first renal transplantation.


RESULTS
One hundred sixteen male patients awaiting their first kidney transplant were identified on our waiting list. Seven of the 42 patients (16.7%) who received at least one unit of leuko-depleted blood developed HLA antibody (HLAab). Of the remaining 74 patients without a history of transfusion, 3 (4.1%) were found to have HLAab. All the antibodies identified were directed against class I antigens. A history of blood transfusion gave a relative risk of 4.1 of developing HLAab (P=0.02).


CONCLUSIONS
Male patients awaiting their first organ transplant had a fourfold increased risk of developing HLA antibody if they had been previously transfused when compared with those who did not have a history of a transfusion. Transfusion even in the postleukodepletion era continues to pose a significant risk of sensitization.
Department of Nephrology and Transplantation, MRC Centre for Transplantation, Guy's and St. Thomas' Hospital, Great Maze Pond, Southwark, London, United Kingdom. gowrie@doctors.net.uk
Gowrie S
GS
Balasubramaniam
Matthew
M
Morris
Arun
A
Gupta
Irene Rebello
IR
Mesa
Raj
R
Thuraisingham
Neil
N
Ashman
D000328:Adult; D000906:Antibodies / Q000097:blood*; D001803:Blood Transfusion; D003430:Cross-Sectional Studies; D006085:Graft Survival / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D016030:Kidney Transplantation / Q000276:immunology; D047589:Leukocyte Reduction Procedures; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015996:Survival Rate; D014850:Waiting Lists
D000906:Antibodies; D006680:HLA Antigens