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. 1978 Feb;187(2):211–218. doi: 10.1097/00000658-197802000-00020

Impact of blood transfusion on renal transplantation.

T C Fuller, F L Delmonico, B Cosimi, C E Huggins, M King, P S Russell
PMCID: PMC1396477  PMID: 343736

Abstract

The relationship between transfusion of different preparations of blood, sensitization to HLA antigens and survival of subsequent kidney transplants was investigated in 90 consecutive recipients. HLA lymphocytotoxins in transplant candidates precluded or greatly delayed receipt of an allograft (p less than 0.0005). Furthermore, only 17% of such sensitized recipients had functioning grafts one year after transplantation compared to 57% survival for nonsensitized recipients (p less than .02). A small number of nonsensitized patients who were never transfused had surprisingly poor one year graft survival (25%). If frozen blood is used for transfusion rather than whole/packed RBC, the incidence of patient sensitization can be markedly reduced without subsequent compromise in transplant survival (51%). It is concluded that as a consequence of avoiding HLA sensitization by transfusion of frozen blood (processed by agglomeration), the period of hemodialysis required for potential graft recipients will be shortened and an increased proportion of potential recipients will be successfully treated by transplantation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Caseley J., Moses V. K., Lichter E. A., Jonasson O. Isoimmunization of hemodialysis patients: leukocyte-poor versus whole blood transfusions. Transplant Proc. 1971 Mar;3(1):365–367. [PubMed] [Google Scholar]
  2. Caves P. K., Stinson E. B., Griepp R. B., Rider A. K., Dong E., Jr, Shumway N. E. Results of 54 cardiac transplants. Surgery. 1973 Aug;74(2):307–314. [PubMed] [Google Scholar]
  3. Cosimi A. B., Wortis H. H., Delmonico F. L., Russell P. S. Randomized clinical trial of antithymocyte globulin in cadaver renal allograft recipients: importance of T cell monitoring. Surgery. 1976 Aug;80(2):155–163. [PubMed] [Google Scholar]
  4. Davies D. A., Staines N. A. A cardinal role for I-region antigens (Ia) in immunological enhancement, and the clinical implications. Transplant Rev. 1976;30:18–39. doi: 10.1111/j.1600-065x.1976.tb00213.x. [DOI] [PubMed] [Google Scholar]
  5. Ferguson R. M., Noreen H., Yunis E. J., Simmons R. L., Najarian J. S. Does "responder"/"nonresponder" status influence renal allograft success? Transplant Proc. 1977 Mar;9(1):69–72. [PubMed] [Google Scholar]
  6. Festenstein H., Sachs J. A., Pegrum G. D., Moorhead J. F., Paris A. M. Influence of HLA matching and blood-transfusion on outcome of 502 London Transplant Group renal-graft recipients. Lancet. 1976 Jan 24;1(7952):157–161. doi: 10.1016/s0140-6736(76)91270-8. [DOI] [PubMed] [Google Scholar]
  7. French M. E., Batchelor J. R. Enhancement of renal allografts in rats and man. Transplant Rev. 1972;13:115–141. doi: 10.1111/j.1600-065x.1972.tb00062.x. [DOI] [PubMed] [Google Scholar]
  8. Hattler B. G., Jr, Young W. G., Jr, Amos D. B., Hutchin P., MacQueen M. White blood cell antibodies. Arch Surg. 1966 Nov;93(5):741–746. doi: 10.1001/archsurg.1966.01330050045006. [DOI] [PubMed] [Google Scholar]
  9. Huggins C. E., Russell P. S., Winn H. J., Fuller T. C., Beck C. H., Jr Frozen blood in transplant patients: hepatitis and HL-A isosensitization. Transplant Proc. 1973 Mar;5(1):809–812. [PubMed] [Google Scholar]
  10. Jeekel J. J., McKenzie I. F., Winn H. J. Immunological enhancement of skin grafts in the mouse. J Immunol. 1972 Apr;108(4):1017–1024. [PubMed] [Google Scholar]
  11. KALISS N. Regression or survival of tumor homoiografts in mice pretreated with injections of lyophilized tissues. Cancer Res. 1952 May;12(5):379–382. [PubMed] [Google Scholar]
  12. MERRELL M., SHULMAN L. E. Determination of prognosis in chronic disease, illustrated by systemic lupus erythematosus. J Chronic Dis. 1955 Jan;1(1):12–32. doi: 10.1016/0021-9681(55)90018-7. [DOI] [PubMed] [Google Scholar]
  13. Marquet R., Heystek G. The induction and abolition of specific immunosuppression of heart allografts in rats by use of donor blood and cyclophosphamide. J Immunol. 1975 Aug;115(2):405–408. [PubMed] [Google Scholar]
  14. Miller W. V., Schmidt R., Luke R. G., Caywood B. E. Effect on cytotoxicity antibodies in potential transplant recipients of leucocyte-poor blood-transfusion. Lancet. 1975 Apr 19;1(7912):893–895. doi: 10.1016/s0140-6736(75)91688-8. [DOI] [PubMed] [Google Scholar]
  15. Opelz G., Mickey M. R., Terasaki P. I. HL-A and kidney transplants: reexamination. Transplantation. 1974 Apr;17(4):371–382. doi: 10.1097/00007890-197404000-00006. [DOI] [PubMed] [Google Scholar]
  16. Opelz G., Terasaki P. I. Poor kidney-transplant survival in recipients with frozen-blood transfusions or no transfusions. Lancet. 1974 Sep 21;2(7882):696–698. doi: 10.1016/s0140-6736(74)93268-1. [DOI] [PubMed] [Google Scholar]
  17. Opelz G., Terasaki P. I. Prolongation effect of blood transfusions on kidney graft survival. Transplantation. 1976 Oct;22(4):380–383. doi: 10.1097/00007890-197610000-00010. [DOI] [PubMed] [Google Scholar]
  18. Persijn G. G., van Hooff J. P., Kalff M. W., Lansbergen Q., van Rood J. J. Effect of blood transfusions and HLA matching on renal transplantation in the Netherlands. Transplant Proc. 1977 Mar;9(1):503–505. [PubMed] [Google Scholar]
  19. Suarez-Ch R., Jonasson O. Isoimmunization of potential kidney transplant recipients: general frequency and some associated factors. Transplant Proc. 1972 Dec;4(4):577–579. [PubMed] [Google Scholar]
  20. Thorsby E. The human major histocompatibility system. Transplant Rev. 1974;18:51–129. [PubMed] [Google Scholar]
  21. Ting A., Mickey M. R., Terasaki P. I. B-lymphocyte alloantigens in Caucasians. J Exp Med. 1976 Apr 1;143(4):981–986. doi: 10.1084/jem.143.4.981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. van Rood J. J., van Leeuwen A., Termijtelen A., Keuning J. J. B-cell antibodies, Ia-like determinants, and their relation to MLC determinants in man. Transplant Rev. 1976;30:122–139. doi: 10.1111/j.1600-065x.1976.tb00218.x. [DOI] [PubMed] [Google Scholar]

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