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Impact of Early Blood Transfusion After Kidney Transplantation on the Incidence of Donor-Specific Anti-HLA Antibodies.
Am J Transplant 2016; 16(9):2661-9AJ

Abstract

Little is known about the impact of posttransplant blood transfusion on the sensitization of anti-HLA antibodies and the formation of donor-specific antibodies (DSAs). The aims of our study were to determine the 1-year incidence of DSAs (assessed using a solid-phase assay) and antibody-mediated rejection (AMR) in kidney transplant patients who had or had not received a blood transfusion during the first year after transplantation. Included were 390 non-HLA-sensitized patients who had received an ABO-compatible kidney transplant and had not previously or simultaneously received a nonkidney transplant. Overall, 64% of patients received a red blood cell transfusion within the first year after transplantation, most within the first month. The overall 1-year incidence of DSAs was significantly higher in patients that had undergone transfusion (7.2% vs. 0.7% in patients with no transfusion, p < 0.0001). AMR occurred more often in the transfusion group (n = 15, 6%) compared with the nontransfusion group (n = 2, 1.4%; p = 0.04). Blood transfusion was an independent predictive factor for de novo DSA formation but not for AMR. Patients who had a transfusion and developed DSAs were more often treated with cyclosporin A (n = 10, 55.5%) rather than tacrolimus (n = 45, 19.4%; p = 0.0001). In conclusion, early posttransplant blood transfusion may increase immunological risk, especially in underimmunosuppressed patients.

Authors+Show Affiliations

Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France. Université Paul Sabatier, Toulouse, France.Université Paul Sabatier, Toulouse, France. Molecular Immunogenetics Laboratory, EA 3034, Faculté de Médecine Purpan, IFR150 (INSERM), Toulouse, France. Department of Immunology, Hôpital de Rangueil, CHU de Toulouse, Toulouse, France.Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France. Université Paul Sabatier, Toulouse, France.Etablissement Français du Sang, CHU Toulouse, Toulouse, France.EA 4275 Biostatistics, Clinical Research and Subjective Measures in Health Sciences, Nantes University, Nantes, France. Institut de Transplantation Urologie Néphrologie (ITUN), Nantes Hospital and University, INSERM 1064, CENTAURE, Nantes, France. LabexTransplantex, CIC biotherapy, Nantes, France.Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France. Université Paul Sabatier, Toulouse, France.Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France. Université Paul Sabatier, Toulouse, France. INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France. Université Paul Sabatier, Toulouse, France. INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26998676

Citation

Ferrandiz, I, et al. "Impact of Early Blood Transfusion After Kidney Transplantation On the Incidence of Donor-Specific Anti-HLA Antibodies." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol. 16, no. 9, 2016, pp. 2661-9.
Ferrandiz I, Congy-Jolivet N, Del Bello A, et al. Impact of Early Blood Transfusion After Kidney Transplantation on the Incidence of Donor-Specific Anti-HLA Antibodies. Am J Transplant. 2016;16(9):2661-9.
Ferrandiz, I., Congy-Jolivet, N., Del Bello, A., Debiol, B., Trébern-Launay, K., Esposito, L., ... Kamar, N. (2016). Impact of Early Blood Transfusion After Kidney Transplantation on the Incidence of Donor-Specific Anti-HLA Antibodies. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 16(9), pp. 2661-9. doi:10.1111/ajt.13795.
Ferrandiz I, et al. Impact of Early Blood Transfusion After Kidney Transplantation On the Incidence of Donor-Specific Anti-HLA Antibodies. Am J Transplant. 2016;16(9):2661-9. PubMed PMID: 26998676.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Early Blood Transfusion After Kidney Transplantation on the Incidence of Donor-Specific Anti-HLA Antibodies. AU - Ferrandiz,I, AU - Congy-Jolivet,N, AU - Del Bello,A, AU - Debiol,B, AU - Trébern-Launay,K, AU - Esposito,L, AU - Milongo,D, AU - Dörr,G, AU - Rostaing,L, AU - Kamar,N, Y1 - 2016/04/19/ PY - 2015/08/27/received PY - 2016/03/08/revised PY - 2016/03/11/accepted PY - 2016/3/22/entrez PY - 2016/3/22/pubmed PY - 2017/11/29/medline KW - alloantibody KW - calcineurin inhibitor: tacrolimus KW - clinical research/practice KW - immunosuppressant KW - kidney transplantation/nephrology KW - transfusion SP - 2661 EP - 9 JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons JO - Am. J. Transplant. VL - 16 IS - 9 N2 - Little is known about the impact of posttransplant blood transfusion on the sensitization of anti-HLA antibodies and the formation of donor-specific antibodies (DSAs). The aims of our study were to determine the 1-year incidence of DSAs (assessed using a solid-phase assay) and antibody-mediated rejection (AMR) in kidney transplant patients who had or had not received a blood transfusion during the first year after transplantation. Included were 390 non-HLA-sensitized patients who had received an ABO-compatible kidney transplant and had not previously or simultaneously received a nonkidney transplant. Overall, 64% of patients received a red blood cell transfusion within the first year after transplantation, most within the first month. The overall 1-year incidence of DSAs was significantly higher in patients that had undergone transfusion (7.2% vs. 0.7% in patients with no transfusion, p < 0.0001). AMR occurred more often in the transfusion group (n = 15, 6%) compared with the nontransfusion group (n = 2, 1.4%; p = 0.04). Blood transfusion was an independent predictive factor for de novo DSA formation but not for AMR. Patients who had a transfusion and developed DSAs were more often treated with cyclosporin A (n = 10, 55.5%) rather than tacrolimus (n = 45, 19.4%; p = 0.0001). In conclusion, early posttransplant blood transfusion may increase immunological risk, especially in underimmunosuppressed patients. SN - 1600-6143 UR - https://www.unboundmedicine.com/medline/citation/26998676/citation/26998676/Impact_of_early_blood_transfusion_after_kidney_transplantation_on_the_incidence_of_donor_specific_anti_HLA_antibodies_ L2 - https://doi.org/10.1111/ajt.13795 DB - PRIME DP - Unbound Medicine ER -