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Kidney Week

Abstract: FR-PO1166

Impact of Peritransplant Red Blood Cell Transfusion on Long-Term Renal Outcome After Kidney Transplantation

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Lee, Kyungho, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Park, Mee yeon, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Song, Seungmin, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Boo, Hyo jin, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Jeon, Junseok, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Lee, Jung eun, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Huh, Wooseong, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yoon-Goo, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Kim, Dae joong, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Ryu, Ho geol, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Jang, Hye Ryoun, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
Background

Patients undergoing kidney transplantation (KT) frequently receive red blood cell (RBC) transfusion perioperatively. Transfusion of blood products may induce allosensitization in KT recipients. The effects of peri-transplant transfusion on graft survival were investigated using a nationwide database.

Methods

Data were collected from the National Healthcare Insurance Service database in Korea. 13,872 patients who received KT in Korea between 2007 and 2015 were analyzed. The outcome measures were graft failure rate at 5 years from KT and overall patient survival depending on the amount of RBC transfusion. Diabetes mellitus, hypertension, coronary artery disease, cerebrovascular disease, transplantation period, and Elixhauser comorbidity index were adjusted as covariates.

Results

The 5-year graft failure rates were 17% in the no transfusion group, 17% in 1-2 units group (OR 0.98 [95% CI 0.84–1.16]), 26% in 3-5 units group (OR 1.51 [95% CI 1.19–1.91]), and 38% in 6 units or more group (OR 2.13 [95% CI 1.39–3.27]) (P < .001, 3-5 units or 6 units or more vs. no transfusion group). The 10-year survival rates were 97% in no transfusion group, 96% in 1-2 units group (OR 1.44 [95% CI 1.19-1.75]), 92% in 3-5 units group (OR 2.38 [95% CI 1.86-3.05]), and 67% in 6 units or more group (OR 10.78 [95% CI 8.47-13.71]) (P <.001, 1-2 units, 3-5 units or 6 or more units group vs no transfusion group).

Conclusion

Peri-transplant RBC transfusions in KT recipients were independently associated with increased risk of renal allograft failure and death. Further studies are required to confirm the risk of allosensitization following blood transfusion and to search for alternative ways to reduce sensitization with blood products.