title: Effect of perioperative blood transfusions on long term graft outcomes in renal transplant patients.
abstract: BACKGROUND
  It is established that blood transfusions will promote sensitization to human leucocyte antigen (HLA) antigens, increase time spent waiting for transplantation and may lead to higher rates of rejection. Less is known about how perioperative blood transfusion influence patient and graft outcome. This study aims to establish if there is an association between perioperative blood transfusion and graft or patient survival.
  
  
  METHODS
  This was a single center, national, retrospective cohort study. Data was collected on patients who received kidney transplants over a 14-year period (n = 2,013). The primary outcomes were graft survival and mortality in patients who received blood transfusions in the perioperative period compared to those who did not.
  
  
  RESULTS
  Patients who received blood transfusions had lower hemoglobin levels, were more likely to be male, and had higher rates of delayed graft function compared to those who did not receive a transfusion. The one year graft survival of those transfused was 83% compared to 94% in those not transfused (p = < 0.0001). Adjustment for confounding showed that the receipt of a blood transfusion remained associated with increased graft loss. Hemoglobin levels prior to transfusion did not have an influence on graft outcome.
  
  
  CONCLUSIONS
  Perioperative blood transfusion is associated with reduced long-term graft survival.
authors.affiliation: Department of Nephrology, Beaumont Hospital, Dublin, Ireland. frankjobrien84@gmail.com
authors.forename: Frank J
authors.initials: FJ
authors.lastname: O'Brien
authors.forename: James
authors.initials: J
authors.lastname: Lineen
authors.forename: Claire M
authors.initials: CM
authors.lastname: Kennedy
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Phelan
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Kelly
authors.forename: Mark D
authors.initials: MD
authors.lastname: Denton
authors.forename: Colm
authors.initials: C
authors.lastname: Magee
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Conlon
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood / Q000150:complications / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion / Q000401:mortality; D051799:Delayed Graft Function / Q000209:etiology* / Q000401:mortality; D005260:Female; D006085:Graft Survival; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007494:Ireland; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019990:Perioperative Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006454:Hemoglobins