BLOOD TRANSFUSIONS AND HLA MATCHING—AN EITHER/OR SITUATION IN CADAVERIC RENAL TRANSPLANTATION1 Pressented at the 6th Annual Meeting of the American Society of Transplant Physicians, May 1987, Chicago, IL


    loading  Checking for direct PDF access through Ovid

Abstract

Cyclosporine-treted recipients of primary cadaver donor renal transplants had a one-year graft survival rate of 79% if they received pretransplant blood transfusions (n=5308). The one-year survival rate for non-transfused recipients (n=709) was significantly lower at 69% (P<0.001). The transfusion effect was larger in black reciopients (a 17% difference) than in white recipients (5%). The effect was also larger in recipients of grafts poorly matched for HLA-A, B, -B, DR, or -DR antigens than in recipients of well-matched grafts. Transfusions did not dignificantly improve graft survival in recipients with zero or one HLA-A, B or -B, DR, or zero-DR-mismatched grafts. However, transfusions accounted for increased of 10%, 14%, adn 17% in patients receiving grafts mismatched at 2, 3, or 4 HLA-B, DR antigens,l respectively. Several factors including cyclosporine and HLA matching have contributed to improving graft survival rates in nontransfused revcipients. Sensitization was noted in 20% of transfused patients awaiting primary renal transplnats in Southern California, as compared with 10% in transplanted patients, suggesting a tendencey to transplant nonsensitized patients. Of the sensitized patients, 75% were female. Based on these date, we suggest that high survival of primary kidney allografts in th ecyclosporine era can best be maintained by the continued use f pretransplant transfusions for the majority of recipients— or, alternatively, by HLA matching for patients who are at higher risk of becoming sensitized

    loading  Loading Related Articles