Red Blood Cell Transfusion Prior to Lung Transplantation: Impact on Patient Outcomes

Area of Science:

• Transplantation immunology
• Hematology

Background:

• Red blood cell (RBC) transfusion is associated with adverse outcomes in cardiac surgery.
• Limited data exists on the impact of pretransplant RBC transfusion in lung transplant recipients.

Purpose of the Study:

• To investigate the association between pretransplant RBC transfusion and patient survival.
• To evaluate the effect of pretransplant RBC transfusion on post-transplantation adverse events.

Main Methods:

• Retrospective analysis of adult lung transplant patient data from the United Network for Organ Sharing (UNOS) thoracic database.
• Stratification of patients into transfused (n=1,415) and not transfused (n=26,802) groups.
• Multivariable survival analysis to assess mortality risk and adverse event incidence.

Main Results:

• Pretransplant transfusion rates showed an increasing trend from 2006 to 2020.
• Transfused patients experienced higher rates of post-transplant dialysis, stroke, and acute organ rejection.
• Pretransplant RBC transfusion was associated with an increased mortality risk (HR: 1.27; 95% CI: 1.17-1.41).
• No significant difference in bronchiolitis obliterans syndrome development was observed between groups.

Conclusions:

• Pretransplant RBC transfusion is associated with increased morbidity and mortality in lung transplant recipients.
• RBC transfusion before lung transplantation does not appear to affect the development of chronic graft rejection.