Mr Nauman Ahmed1, Mr Konrad Feng1
1University Of Sydney, Camperdown, Australia
Aim:
Determine the effects that blood transfusions have on kidney transplant outcomes
Background:
The use of transfusions in kidney transplant medicine has long been a point of contention. While they are a solution to the anemia plaguing this patient population, they can also induce a sensitized state, increasing the risk for poorer graft outcomes. Recently, however, with the advent of tacrolimus and with transfusions primarily being given in the post-transplant period only when they are clinically indicated, transfusions may not pose the same risk. No meta-analyses have been published including these newer studies. Therefore, we believed it prudent to undertake a systematic review and meta-analysis exploring the effect transfusions have on transplant outcomes.
Methods:
A systematic search was conducted using MEDLINE, Embase, Cochrane library and Clinicaltrals.gov. Including only English articles published between 1/1/2000 and 01/03/2022, we found 9 studies that met our inclusion criteria. A meta-analysis was thereby carried out comparing delayed graft function, the development of de novo DSA, and antibody mediated rejection.
Results:
Low-level evidence exists for no difference or an increase in DGF and AMR for participants who received at least one blood transfusion. Low-level evidence exists for an increase in AMR for participants who received at least one blood transfusion. No study reported any improvement with blood transfusion usage.
Conclusion:
The transfusion effect appears not to exist in the 21st century even in patients receiving postoperative blood transfusions. However, while transfusions are avoided wherever possible, transfusions in kidney transplant recipients do not appear to be associated with any worse outcomes compared to their non transfused counterparts. While more research is required, clinicians may be able to administer blood transfusions to these patients with a clear conscience.
Biography:
Bio to come