[Hemotherapy in kidney transplantation]

A total of 40 kidney transplantations (37 males and 3 females) from living donors (Group I) and 10 kidney transplantations (6 males and 4 females) from cadavers (Group II) were performed in the period 1996-October 1999 at the Military Medical Academy (MMA). Lymphocytotoxic crossmatching was done before each kidney transplantation and results from all tests were negative for all recipients. All donors had the same blood group in ABO system as the recipients. In perioperative transfusion treatment (hemotherapy) determined quantity of filtered red blood cells (F-RBCs) and/or filtered platelets (F-PLT) were given to recipients according to intraoperative blood loss and their clinical state. Leukoreduction filters were used to prevent HLA alloimmunization. In only 4 (8%) recipients in group I transfusion therapy was not applied perioperatively. An average of 3.27 units of F-RBCs (929.44 mL) was used intraoperatively in 36 (72%) recipients in group I, an average of 1.9 units of F-RBCs (521 mL) was used before kidney transplantation in 10 (20%) recipients in group I and an average of 2.65 units of F-RBCs (739.23 mL) was used postoperatively in 26 (52%) recipients. In all recipients from group II transfusion therapy was applied perioperatively. An average of 3.4 units of F-RBCs (953 mL) was used intraoperatively. An average of 4.9 units (1.328 mL) and an average of 1.4 units of F-PLT were used postoperatively. All recipients well tolerated the therapy and no adverse effects of the therapy were observed. The need for transfusion therapy intraoperatively was approximatively same in both recipient groups, while in recipients from cadavers need for transfusion support in posttransplantation period was much higher.