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Influence of HLA matching and blood transfusion on renal allograft survival
Insights
Improved kidney transplant outcomes are linked to better Human Leukocyte Antigen (HLA) matching and blood transfusions. Pre-transplant transfusions significantly reduce graft failure rates, highlighting their crucial role in renal transplantation success.
Area of Science:
- Nephrology
- Immunology
- Transplantation
Background:
- Human Leukocyte Antigen (HLA) matching is crucial for transplant success.
- The role of pre-transplant blood transfusions in renal transplantation outcomes requires further clarification.
Purpose of the Study:
- To evaluate the impact of HLA matching and blood transfusions on cadaveric kidney transplant outcomes.
- To assess the influence of pre-transplant blood transfusion status on graft survival.
Main Methods:
- Analysis of 107 consecutive cadaveric kidney transplants followed for up to 6 years.
- Comparison of graft failure rates based on HLA incompatibility levels and pre-transplant transfusion history.
Main Results:
- Grafts with fewer than two HLA incompatibilities had a 2-year rejection failure rate of 29%, versus 52% with two or more incompatibilities.
- Patients not transfused pre-transplant had a 1-year graft failure rate of 72%, significantly higher than those transfused (29-23%).
- The beneficial effect of blood transfusion was observed regardless of the number of units transfused (less than five vs. more than five).
Conclusions:
- HLA matching significantly improves kidney graft survival.
- Pre-transplant blood transfusion is a critical factor positively influencing renal transplant outcomes.
- Blood transfusion appears to have a substantial impact on the success of kidney transplantation.
Abstract:
One hundred and seven consecutive cadaver kidney transplants have been followed for up to 6 years. The beneficial effect of HLA matching, shown in previous studies, has been confirmed. The 2-year failure rate from rejection was 29% for grafts with less than two incompatibilities, in comparison with a figure of 52% where there were two or more incompatibilities. In contrast to some reports, the presence of HLA antibodies did not have an adverse effect on the survival of first grafts. Patients not transfused prior to transplantation had a much higher 1-year graft failure rate (72%) than those given either frozen-thawed red cells (29%) or whole blood (23%). This apparently beneficial effect of blood transfusion was no greater in patients transfused with more than five units compared with those given less than five units. We believe that blood transfusion has an important influence on the outcome of renal transplantation.