Pre-kidney-transplant blood transfusions do not improve transplantation outcome: a Dutch national study

Background. Female renal transplant candidates are prone to be sensitized by prior pregnancies, and undetected historical sensitization might decrease transplantation outcome. Hypothesis of our study was that pre-transplant blood transfusions (PTFs) can elucidate historical sensitization and that th...

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Veröffentlicht in:Nephrology, dialysis, transplantation dialysis, transplantation, 2009-08, Vol.24 (8), p.2559-2566
Hauptverfasser: Aalten, Jeroen, Bemelman, Frederike J., van den Berg-Loonen, Ella M., Claas, Frans H., Christiaans, Maarten H., de Fijter, Johan W., Hepkema, Bouke G., Hené, Ronald J., van der Heide, Jaap J. Homan, van Hooff, Johannes P., Lardy, Neubury M., Lems, Simon P., Otten, Henderikus G., Weimar, Willem, Allebes, Wil A., Hoitsma, Andries J.
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container_end_page 2566
container_issue 8
container_start_page 2559
container_title Nephrology, dialysis, transplantation
container_volume 24
creator Aalten, Jeroen
Bemelman, Frederike J.
van den Berg-Loonen, Ella M.
Claas, Frans H.
Christiaans, Maarten H.
de Fijter, Johan W.
Hepkema, Bouke G.
Hené, Ronald J.
van der Heide, Jaap J. Homan
van Hooff, Johannes P.
Lardy, Neubury M.
Lems, Simon P.
Otten, Henderikus G.
Weimar, Willem
Allebes, Wil A.
Hoitsma, Andries J.
description Background. Female renal transplant candidates are prone to be sensitized by prior pregnancies, and undetected historical sensitization might decrease transplantation outcome. Hypothesis of our study was that pre-transplant blood transfusions (PTFs) can elucidate historical sensitization and that the avoidance of the associated antigens can improve transplantation outcome. Methods. Data from all female non-immunized renal transplant candidates who received a random PTF (rPTF) (n = 620), matched PTF (mPTF) (one HLA-A and B and one HLA-DR match) (n = 86) or donor-specific blood transfusion (DST) (n = 100) between 1996 and 2006 were collected. Complement-dependent cytoxicity was used to detect anti-HLA antibodies. Sensitization and transplantation outcomes after a PTF were analyzed. Non-immunized female renal transplant recipients who did not receive a PTF were used as the control group. Results. In 165 patients, anti-HLA antibodies (IgG) were detected after the PTF. Both historical and primary sensitizations were found. A DST induced donor-specific anti-HLA antibodies in 25% of the DST recipients. Our policy did not improve transplantation outcome in recipients of a kidney from a deceased donor (n = 368) or in recipients of a living donor [DST (n = 49) and mPTF (n = 66)]. Conclusions. A PTF did elucidate historical sensitization but induce primary sensitization as well. No beneficial effect of PTFs on transplantation outcome was found, and PTFs with the intention to detect historical sensitization are therefore not suggested.
doi_str_mv 10.1093/ndt/gfp233
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Homan ; van Hooff, Johannes P. ; Lardy, Neubury M. ; Lems, Simon P. ; Otten, Henderikus G. ; Weimar, Willem ; Allebes, Wil A. ; Hoitsma, Andries J.</creator><creatorcontrib>Aalten, Jeroen ; Bemelman, Frederike J. ; van den Berg-Loonen, Ella M. ; Claas, Frans H. ; Christiaans, Maarten H. ; de Fijter, Johan W. ; Hepkema, Bouke G. ; Hené, Ronald J. ; van der Heide, Jaap J. Homan ; van Hooff, Johannes P. ; Lardy, Neubury M. ; Lems, Simon P. ; Otten, Henderikus G. ; Weimar, Willem ; Allebes, Wil A. ; Hoitsma, Andries J.</creatorcontrib><description>Background. Female renal transplant candidates are prone to be sensitized by prior pregnancies, and undetected historical sensitization might decrease transplantation outcome. Hypothesis of our study was that pre-transplant blood transfusions (PTFs) can elucidate historical sensitization and that the avoidance of the associated antigens can improve transplantation outcome. Methods. Data from all female non-immunized renal transplant candidates who received a random PTF (rPTF) (n = 620), matched PTF (mPTF) (one HLA-A and B and one HLA-DR match) (n = 86) or donor-specific blood transfusion (DST) (n = 100) between 1996 and 2006 were collected. Complement-dependent cytoxicity was used to detect anti-HLA antibodies. Sensitization and transplantation outcomes after a PTF were analyzed. Non-immunized female renal transplant recipients who did not receive a PTF were used as the control group. Results. In 165 patients, anti-HLA antibodies (IgG) were detected after the PTF. Both historical and primary sensitizations were found. A DST induced donor-specific anti-HLA antibodies in 25% of the DST recipients. Our policy did not improve transplantation outcome in recipients of a kidney from a deceased donor (n = 368) or in recipients of a living donor [DST (n = 49) and mPTF (n = 66)]. Conclusions. A PTF did elucidate historical sensitization but induce primary sensitization as well. No beneficial effect of PTFs on transplantation outcome was found, and PTFs with the intention to detect historical sensitization are therefore not suggested.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfp233</identifier><identifier>PMID: 19474284</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>acute rejection ; Adolescent ; Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood Transfusion ; Case-Control Studies ; Child ; Emergency and intensive care: renal failure. Dialysis management ; Female ; graft survival ; Graft Survival - immunology ; Histocompatibility ; HLA Antigens - immunology ; Humans ; Intensive care medicine ; kidney ; Kidney Transplantation ; Male ; Medical sciences ; Middle Aged ; pre-transplant blood transfusion ; Preoperative Care ; Retrospective Studies ; sensitization ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Tissue Donors ; Treatment Outcome ; Young Adult</subject><ispartof>Nephrology, dialysis, transplantation, 2009-08, Vol.24 (8), p.2559-2566</ispartof><rights>Oxford University Press © The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org 2009</rights><rights>2009 INIST-CNRS</rights><rights>The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-7e03bb151421161eec129e28bcca0723512abf28fd4377cfbb019e63c9aad82c3</citedby><cites>FETCH-LOGICAL-c446t-7e03bb151421161eec129e28bcca0723512abf28fd4377cfbb019e63c9aad82c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,1586,27931,27932</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=21798315$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19474284$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aalten, Jeroen</creatorcontrib><creatorcontrib>Bemelman, Frederike J.</creatorcontrib><creatorcontrib>van den Berg-Loonen, Ella M.</creatorcontrib><creatorcontrib>Claas, Frans H.</creatorcontrib><creatorcontrib>Christiaans, Maarten H.</creatorcontrib><creatorcontrib>de Fijter, Johan W.</creatorcontrib><creatorcontrib>Hepkema, Bouke G.</creatorcontrib><creatorcontrib>Hené, Ronald J.</creatorcontrib><creatorcontrib>van der Heide, Jaap J. Homan</creatorcontrib><creatorcontrib>van Hooff, Johannes P.</creatorcontrib><creatorcontrib>Lardy, Neubury M.</creatorcontrib><creatorcontrib>Lems, Simon P.</creatorcontrib><creatorcontrib>Otten, Henderikus G.</creatorcontrib><creatorcontrib>Weimar, Willem</creatorcontrib><creatorcontrib>Allebes, Wil A.</creatorcontrib><creatorcontrib>Hoitsma, Andries J.</creatorcontrib><title>Pre-kidney-transplant blood transfusions do not improve transplantation outcome: a Dutch national study</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><addtitle>Nephrol Dial Transplant</addtitle><description>Background. Female renal transplant candidates are prone to be sensitized by prior pregnancies, and undetected historical sensitization might decrease transplantation outcome. Hypothesis of our study was that pre-transplant blood transfusions (PTFs) can elucidate historical sensitization and that the avoidance of the associated antigens can improve transplantation outcome. Methods. Data from all female non-immunized renal transplant candidates who received a random PTF (rPTF) (n = 620), matched PTF (mPTF) (one HLA-A and B and one HLA-DR match) (n = 86) or donor-specific blood transfusion (DST) (n = 100) between 1996 and 2006 were collected. Complement-dependent cytoxicity was used to detect anti-HLA antibodies. Sensitization and transplantation outcomes after a PTF were analyzed. Non-immunized female renal transplant recipients who did not receive a PTF were used as the control group. Results. In 165 patients, anti-HLA antibodies (IgG) were detected after the PTF. Both historical and primary sensitizations were found. A DST induced donor-specific anti-HLA antibodies in 25% of the DST recipients. Our policy did not improve transplantation outcome in recipients of a kidney from a deceased donor (n = 368) or in recipients of a living donor [DST (n = 49) and mPTF (n = 66)]. Conclusions. A PTF did elucidate historical sensitization but induce primary sensitization as well. No beneficial effect of PTFs on transplantation outcome was found, and PTFs with the intention to detect historical sensitization are therefore not suggested.</description><subject>acute rejection</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood Transfusion</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>graft survival</subject><subject>Graft Survival - immunology</subject><subject>Histocompatibility</subject><subject>HLA Antigens - immunology</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>kidney</subject><subject>Kidney Transplantation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>pre-transplant blood transfusion</subject><subject>Preoperative Care</subject><subject>Retrospective Studies</subject><subject>sensitization</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Tissue Donors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90M9rFDEUB_AgSrv9cfEPkCC0B2FsXpKZJL2Vql1xoaUoipeQyWTqtDOTMcmI-98bu0sXPHhKeO_Dy8sXoZdA3gJR7Gxs0tldO1HGnqEF8IoUlMnyOVrkJhSkJGofHcR4TwhRVIg9tA-KC04lX6C7m-CKh64Z3bpIwYxx6s2YcN173-DHQjvHzo8RNx6PPuFumIL_5fAOm5T72M_J-sGdY4Pf5esPPD7WTY9jmpv1EXrRmj664-15iL58eP_5clmsrq8-Xl6sCst5lQrhCKtrKIFTgAqcs0CVo7K21hBBWQnU1C2VbcOZELatawLKVcwqYxpJLTtEp5u5ecufs4tJD120rs-LOj9HXQmuKAGS4et_4L2fQ943agoSJIVSZvRmg2zwMQbX6il0gwlrDUT_zV7n7PUm-4xfbSfO9eCaHd2GncHJFphoTd_mBG0XnxwFoSSDcuf8PP3_wWLjupjc7ydpwkP-JhOlXn77rpefKrX6ervSV-wPbY-qng</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>Aalten, Jeroen</creator><creator>Bemelman, Frederike J.</creator><creator>van den Berg-Loonen, Ella M.</creator><creator>Claas, Frans H.</creator><creator>Christiaans, Maarten H.</creator><creator>de Fijter, Johan W.</creator><creator>Hepkema, Bouke G.</creator><creator>Hené, Ronald J.</creator><creator>van der Heide, Jaap J. 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Dialysis management</topic><topic>Female</topic><topic>graft survival</topic><topic>Graft Survival - immunology</topic><topic>Histocompatibility</topic><topic>HLA Antigens - immunology</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>kidney</topic><topic>Kidney Transplantation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>pre-transplant blood transfusion</topic><topic>Preoperative Care</topic><topic>Retrospective Studies</topic><topic>sensitization</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Tissue Donors</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aalten, Jeroen</creatorcontrib><creatorcontrib>Bemelman, Frederike J.</creatorcontrib><creatorcontrib>van den Berg-Loonen, Ella M.</creatorcontrib><creatorcontrib>Claas, Frans H.</creatorcontrib><creatorcontrib>Christiaans, Maarten H.</creatorcontrib><creatorcontrib>de Fijter, Johan W.</creatorcontrib><creatorcontrib>Hepkema, Bouke G.</creatorcontrib><creatorcontrib>Hené, Ronald J.</creatorcontrib><creatorcontrib>van der Heide, Jaap J. Homan</creatorcontrib><creatorcontrib>van Hooff, Johannes P.</creatorcontrib><creatorcontrib>Lardy, Neubury M.</creatorcontrib><creatorcontrib>Lems, Simon P.</creatorcontrib><creatorcontrib>Otten, Henderikus G.</creatorcontrib><creatorcontrib>Weimar, Willem</creatorcontrib><creatorcontrib>Allebes, Wil A.</creatorcontrib><creatorcontrib>Hoitsma, Andries J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aalten, Jeroen</au><au>Bemelman, Frederike J.</au><au>van den Berg-Loonen, Ella M.</au><au>Claas, Frans H.</au><au>Christiaans, Maarten H.</au><au>de Fijter, Johan W.</au><au>Hepkema, Bouke G.</au><au>Hené, Ronald J.</au><au>van der Heide, Jaap J. Homan</au><au>van Hooff, Johannes P.</au><au>Lardy, Neubury M.</au><au>Lems, Simon P.</au><au>Otten, Henderikus G.</au><au>Weimar, Willem</au><au>Allebes, Wil A.</au><au>Hoitsma, Andries J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pre-kidney-transplant blood transfusions do not improve transplantation outcome: a Dutch national study</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><stitle>Nephrol Dial Transplant</stitle><addtitle>Nephrol Dial Transplant</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>24</volume><issue>8</issue><spage>2559</spage><epage>2566</epage><pages>2559-2566</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Background. Female renal transplant candidates are prone to be sensitized by prior pregnancies, and undetected historical sensitization might decrease transplantation outcome. Hypothesis of our study was that pre-transplant blood transfusions (PTFs) can elucidate historical sensitization and that the avoidance of the associated antigens can improve transplantation outcome. Methods. Data from all female non-immunized renal transplant candidates who received a random PTF (rPTF) (n = 620), matched PTF (mPTF) (one HLA-A and B and one HLA-DR match) (n = 86) or donor-specific blood transfusion (DST) (n = 100) between 1996 and 2006 were collected. Complement-dependent cytoxicity was used to detect anti-HLA antibodies. Sensitization and transplantation outcomes after a PTF were analyzed. Non-immunized female renal transplant recipients who did not receive a PTF were used as the control group. Results. In 165 patients, anti-HLA antibodies (IgG) were detected after the PTF. Both historical and primary sensitizations were found. A DST induced donor-specific anti-HLA antibodies in 25% of the DST recipients. Our policy did not improve transplantation outcome in recipients of a kidney from a deceased donor (n = 368) or in recipients of a living donor [DST (n = 49) and mPTF (n = 66)]. Conclusions. A PTF did elucidate historical sensitization but induce primary sensitization as well. No beneficial effect of PTFs on transplantation outcome was found, and PTFs with the intention to detect historical sensitization are therefore not suggested.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>19474284</pmid><doi>10.1093/ndt/gfp233</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects acute rejection
Adolescent
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood Transfusion
Case-Control Studies
Child
Emergency and intensive care: renal failure. Dialysis management
Female
graft survival
Graft Survival - immunology
Histocompatibility
HLA Antigens - immunology
Humans
Intensive care medicine
kidney
Kidney Transplantation
Male
Medical sciences
Middle Aged
pre-transplant blood transfusion
Preoperative Care
Retrospective Studies
sensitization
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Tissue Donors
Treatment Outcome
Young Adult
title Pre-kidney-transplant blood transfusions do not improve transplantation outcome: a Dutch national study
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