PROSPECTIVE EVALUATION OF PRETRANSPLANT BLOOD-TRANSFUSIONS IN CADAVERKIDNEY RECIPIENTS

Background. A beneficial effect of pretransplant transfusions on graft survival was demonstrated in the early 1970s. In the mid-1980s, howev er, retrospective studies showed that transfusions had lost their graf t-protective effect in the cyclosporine era. During the last 10 years, deliberate transfusion pretreatment of transplant patients has been d iscontinued. Methods. Within a collaborative project of 14 transplant centers, prospective recipients of cadaver kidney grafts were randomiz ed to receive either three pretransplant transfusions or transplants w ithout transfusions. Results. The graft survival rate was significantl y higher in the 205 transfusion recipients than in the 218 patients wh o did not receive transfusions (at 1 year: 90+/-2% vs. 82+/-3%, P=0.02 0; at 5 years: 79+/-3% vs. 70+/-4%, P=0.025). Cox regression analysis showed that this effect was independent of age, gender, underlying dis ease, prophylaxis with antilymphocyte antibodies, and preformed lympho cytotoxins. Conclusions. Transfusion pretreatment improves the outcome of cadaver kidney transplants even with the use of modern immunosuppr essive regimens.