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Leukocyte reduction of red blood cell transfusions does not decrease allosensitization rates in potential kidney

Martin Karpinski1, Denise Pochinco, Iga Dembinski

  • 1Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. mkarpinski@hsc.mb.ca

Journal of the American Society of Nephrology : JASN
|February 24, 2004
PubMed
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Leukocyte reduction (leukoreduction) of blood products does not prevent allosensitization in kidney transplant candidates. Previous pregnancy remains the primary risk factor for transfusion-associated sensitization in this population.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Hematology

Background:

  • Potential kidney transplant candidates often require blood transfusions, risking allosensitization.
  • Leukocyte reduction (leukoreduction) reduces allosensitization in hematologic malignancies, but its effect in kidney transplant candidates is unknown.

Purpose of the Study:

  • To evaluate the efficacy of universal leukoreduction of red blood cell transfusions in preventing transfusion-associated allosensitization among potential kidney transplant candidates.

Main Methods:

  • Retrospective analysis of 112 kidney transplant candidates receiving red blood cell transfusions.
  • Comparison of allosensitization rates before (non-LR) and after (LR) implementation of universal leukoreduction.

Main Results:

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  • No significant difference in allosensitization rates between non-LR (27%) and LR (33%) groups.
  • Previous pregnancy identified as the sole significant risk factor for allosensitization (RR 8.2).
  • Leukoreduction showed no protective effect in any subgroup.

Conclusions:

  • Universal leukoreduction of red blood cell transfusions does not protect potential kidney transplant candidates from allosensitization.
  • Continued emphasis on transfusion avoidance and exploration of alternative strategies are crucial for patients with end-stage renal disease (ESRD).