title: Impact of Early Blood Transfusion After Kidney Transplantation on the Incidence of Donor-Specific Anti-HLA Antibodies.
abstract: Little is known about the impact of posttransplant blood transfusion on the sensitization of anti-HLA antibodies and the formation of donor-specific antibodies (DSAs). The aims of our study were to determine the 1-year incidence of DSAs (assessed using a solid-phase assay) and antibody-mediated rejection (AMR) in kidney transplant patients who had or had not received a blood transfusion during the first year after transplantation. Included were 390 non-HLA-sensitized patients who had received an ABO-compatible kidney transplant and had not previously or simultaneously received a nonkidney transplant. Overall, 64% of patients received a red blood cell transfusion within the first year after transplantation, most within the first month. The overall 1-year incidence of DSAs was significantly higher in patients that had undergone transfusion (7.2% vs. 0.7% in patients with no transfusion, p < 0.0001). AMR occurred more often in the transfusion group (n = 15, 6%) compared with the nontransfusion group (n = 2, 1.4%; p = 0.04). Blood transfusion was an independent predictive factor for de novo DSA formation but not for AMR. Patients who had a transfusion and developed DSAs were more often treated with cyclosporin A (n = 10, 55.5%) rather than tacrolimus (n = 45, 19.4%; p = 0.0001). In conclusion, early posttransplant blood transfusion may increase immunological risk, especially in underimmunosuppressed patients.
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.|Université Paul Sabatier, Toulouse, France.
authors.forename: I
authors.initials: I
authors.lastname: Ferrandiz
authors.affiliation: Université Paul Sabatier, Toulouse, France.|Molecular Immunogenetics Laboratory, EA 3034, Faculté de Médecine Purpan, IFR150 (INSERM), Toulouse, France.|Department of Immunology, Hôpital de Rangueil, CHU de Toulouse, Toulouse, France.
authors.forename: N
authors.initials: N
authors.lastname: Congy-Jolivet
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.|Université Paul Sabatier, Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Del Bello
authors.affiliation: Etablissement Français du Sang, CHU Toulouse, Toulouse, France.
authors.forename: B
authors.initials: B
authors.lastname: Debiol
authors.affiliation: EA 4275 Biostatistics, Clinical Research and Subjective Measures in Health Sciences, Nantes University, Nantes, France.|Institut de Transplantation Urologie Néphrologie (ITUN), Nantes Hospital and University, INSERM 1064, CENTAURE, Nantes, France.|LabexTransplantex, CIC biotherapy, Nantes, France.
authors.forename: K
authors.initials: K
authors.lastname: Trébern-Launay
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: L
authors.initials: L
authors.lastname: Esposito
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors.forename: D
authors.initials: D
authors.lastname: Milongo
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.|Université Paul Sabatier, Toulouse, France.
authors.forename: G
authors.initials: G
authors.lastname: Dörr
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.|Université Paul Sabatier, Toulouse, France.|INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.
authors.forename: L
authors.initials: L
authors.lastname: Rostaing
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.|Université Paul Sabatier, Toulouse, France.|INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.
authors.forename: N
authors.initials: N
authors.lastname: Kamar
mesh_terms: D016022:Case-Control Studies; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000453:epidemiology* / Q000209:etiology; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D015994:Incidence; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014019:Tissue Donors
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies
keywords: alloantibody; calcineurin inhibitor: tacrolimus; clinical research/practice; immunosuppressant; kidney transplantation/nephrology; transfusion