Blood transfusions affect the incidence of rejection but not graft survival in HLA-identical renal transplants

Previous studies have suggested a beneficial effect of blood transfusions, but the patient groups were relatively small (< 40 patients). We therefore chose to analyze the collective experience of five transplant centers associated with the Greater Delaware Valley Society of Transplant Surgeons to determine the effect of pretransplant blood transfusion on the outcome of HLA-ID living related renal transplants. The data presented herein show that pretransplant transfusions are associated with a greater incidence of total rejections per patient, but this increased occurrence of rejections with transfused recipients did not result in a statistically significant lower allograft survival rate. Our finding that transfused HLA-ID recipients have a greater number of total rejections per patient has not been previously observed, and the explanation for this is unclear. Other clinical studies have been fewer than 40 patients, and our results with 110 recipients may reflect a much larger patient sample. The results of this multicenter review suggest that, in view of the increased rejections per patients with transfusions, each transplant program should cautiously approach the practice of deliberate third-party, pretransplant transfusion in the potential HLA-ID transplant recipient.