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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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&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. Homan</creator><creator>van Hooff, Johannes P.</creator><creator>Lardy, Neubury M.</creator><creator>Lems, Simon P.</creator><creator>Otten, Henderikus G.</creator><creator>Weimar, Willem</creator><creator>Allebes, Wil A.</creator><creator>Hoitsma, Andries J.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20090801</creationdate><title>Pre-kidney-transplant blood transfusions do not improve transplantation outcome: a Dutch national study</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-7e03bb151421161eec129e28bcca0723512abf28fd4377cfbb019e63c9aad82c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>acute rejection</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood Transfusion</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Emergency and intensive care: renal failure. 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 & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & 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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