Effects of Early Post-Transplant Blood Transfusion on Graft Outcome in Pediatric Renal Transplant Recipients

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Abstract

Introduction

Anemia is commonly observed in early post-transplant period. Blood transfusion is the most frequent using procedure in correction of anemia. However early post transplant blood transfusions may increase immunological risks, antibody formation and rejection. There is little information on the impact of post-transplant transfusions in children. We aimed to evaluate effects of early post-transplant blood transfusion on graft outcome in pediatric renal transplant recipients

Materials and Methods

We retrospectively evaluated the data of 97 renal transplant patients. Demographic data of patients, etiology of renal failure, donor types, rejections, infections, and graft outcomes were recorded. We have documented all blood transfusions given within the first one month after transplantation. All transfused blood components were leuko-depleted. Data of patients with transfused and non-transfused were compared with respect of renal outcome.

Results

A total of 97 patients were included study (F/M:44/52). Mean transplant age of the patients was 14.43±4.76 years and the mean duration of follow-up was 48±12.76 months. Twenty two patients (22.6 %) had received a blood transfusion within the first month after transplantation. Transfused patients had significantly younger than non-transfused patients (9.1±3.2, 12.7±4.5 respectively, p<0.05). The median time for first blood transfusion was 2 days (0-30 days), the median number of transfusions was 1 (range:1-7) after renal transplantation. The indications of blood transfusions were acute hemorrhage, infections, and decreased Hemoglobin levels. The proportion of donor types, gender, HLA mismatch and immunosuppressive treatments were similar in both groups. Also, frequency of acute and chronic rejection, graft loss, PRA formation, first and third year GFR and graft survival were not significantly different (p>0.05)

Conclusion

Post transplant blood transfusions are common in children especially in young patients. Our study showed that early transfusions have no negative association with increased acute and chronic rejection, PRA production and graft loss. Further studies are needed for better evaluate the long-term risk of post-transplant blood transfusions in kidney recipients.

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