Early Post-Transplant Blood Transfusion and Risk for Worse Graft Outcomes

Abstract Background Blood transfusion is a risk factor for allosensitization. Nevertheless, blood transfusion post-transplant remains a common practice. We evaluated the effect of post-transplant blood transfusion on graft outcomes. Methods We included non-sensitized, first time, kidney alone recipients transplanted between July 1, 2015 and December 31, 2017. Patients were grouped based on receiving blood transfusion in the first 30 days post-transplant. Primary endpoint was a composite outcome of biopsy proven acute rejection, death of any cause, or graft failure in the first year post-transplant. Secondary outcomes included the individual components of the primary outcome and the cumulative incidence of de novo donor specific antibodies (DSA). Results 273 patients were included. 127 (47 %) received blood transfusion. Patients in the transfusion group were more likely to be older, have had a deceased donor, and have received induction with Basiliximab. There was no difference between groups in the composite primary outcome (adjusted hazard ration (HR) 1.34, 95% CI: 0.83-2.17, P = 0.23). The cumulative incidence of de novo DSA during the first year post-transplant was similar between groups (12.8% transfusion vs 10.9% no transfusion, P = 0.48). Conclusion Early transfusion of blood products in kidney transplant recipients receiving induction with lymphocytes depletion was not associated with an increased hazard of experiencing acute rejection, death from any cause, or graft loss.