Effects of Perioperative Blood Transfusion on Renal Allograft Rejection and Graft Survival.
- Author:
Bum Suk KWAK
1
;
Hyuk Jai JANG
;
Song Cheol KIM
;
Duck Jong HAN
Author Information
1. Department of Surgery, University of Ulsan, College of Medicine, Asan Medical Center, Korea.
- Publication Type:Original Article
- Keywords:
Renal allograft;
Blood transfusion;
Immunomodulation;
Rejection;
Graft survival
- MeSH:
Allografts*;
Azathioprine;
Biopsy;
Blood Transfusion*;
Cadaver;
Cyclosporine;
Follow-Up Studies;
Graft Survival*;
Humans;
Immunomodulation;
Retrospective Studies;
Transplants*
- From:The Journal of the Korean Society for Transplantation
1999;13(2):249-256
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Many renal allograft patients were received blood transfusions in the pre- or posttransplant period. Before cyclosporine era, many studies showed that immunomodulation which induced by blood transfusion before renal allograft improved graft survival. However, the graft-protective effects of blood transfusion have been questioned in the recent studies. We compared the effects of perioperative blood transfusion on renal allograft rejection and graft survival in transfusion and nontransfusion groups. METHODS: 462 patients (127 cadaveric v.s 335 living) who were received renal allograft from January, 1994 to December, 1997 in our center were grouped into the transfusion and nontransfusion group. All the patients received same triple immunosuppressive regimens (cyclosporine, azathioprine, prednisone). Rejection and graft survival were analyzed retrospectively. Mean follow up period was 838 days (range: 5-1,640). RESULTS: Out of 462 patients, 389 (84.2%) were transfused and mean transfused volume was 4.56 0.38 pints. 73 (15.8%) showed rejection on biopsy. The transfusion group showed 61 (15.7%) rejections and nontransfusion group showed 12 (16.4%) rejections. There was no statistically significant difference of rejection between transfusion and nontransfusion group (p=0.86). Regardless of cadaveric and living renal allograft group, there was no difference of blood transfusion effect on rejection (p=0.53 v.s p=0.98). Rejection was one of the negative factor affecting graft survival significantly (p=0.00). In terms of graft survival, there was no difference between the transfusion and nontransfusion group (p=0.11) CONCLUSION: We conclude that pre- and posttransplant blood transfusions have no detectable beneficial or harmful effects on rejection and graft survival in renal allograft under the current cyclosporine based immunosuppressive medication.
