Frequency of Blood Transfusion Episodes after Kidney Transplantation Is Associated with Development of Class II Donor Specific Antibodies

A. Faravardeh, M. Eickhoff, S. Jackson, N. Issa, T. Dunn, A. Matas, H. Ibrahim

Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, MN
Department of Surgery, University of Minnesota, Minneapolis, MN

Meeting: 2013 American Transplant Congress

Abstract number: 532

Topic:

Background:

The risk of blood transfusions after kidney transplantation for development of DSA is understudied and has generally been evaluated in terms of the total number of blood transfusions given.

Purpose:

We evaluated the effect of blood transfusions after kidney transplantation on development of DSA not only in terms of the total blood transfusions given, but also in terms of how these transfusions were dispersed over time.

Methods:

We studied 143 kidney transplant patients with anemia and 1) the total number of transfusions received, and 2) how these transfusions were given over time: the number of distinct transfusion episodes.* We determined DSA (Class I and II), and mean fluorescence intensity (MFI) after receiving transfusions.

Results:

103, 16, and 24 patients had their first blood transfusion within one month, between 1-3 months, and after 3 months of transplant, respectively, and 6, 117, and 20 patients had zero, one, and two or more blood transfusion episodes, respectively. The total number of transfusions did not affect the probability of developing a positive DSA. In contrast, the number of distinct transfusion episodes was significantly associated with development of Class II DSA. (Table 1)

Table 1. Effect of Blood Transfusions on DSA.
	Likelihood of Positive DSA		Increase in MFI
	Class I	Class II	Class I and II
Effect of One Additional Blood Transfusion	OR = 1.11** (95% CI, 0.93-1.34)	OR = 1.09** (95% CI, 0.98-1.21)	254 (P<0.001)
Effect of One Additional Blood Transfusion Episode*	OR = 1.72** (95% CI, 0.89-3.31)	OR 1.54 (95% CI, 1.03-2.30) P=0.037	429 (P=0.010)

* Blood Transfusion Episode is defined as 1 or more blood transfusions at least 2 weeks apart from other transfusion(s); ** P>0.05.

Conclusion:

To the best of our knowledge, this is the first study that has evaluated the effect of blood transfusions after kidney transplantation on development of DSA not only in terms of the total number of blood transfusions given, but also in terms of how these blood transfusions were given over time. We demonstrate that an increased number of distinct blood transfusion episodes, irrespective of the total number of blood transfusions given, is significantly associated with the development of Class II DSA. Whether this will translate into more adverse clinical events requires longer term follow up.

To cite this abstract in AMA style:

Faravardeh A, Eickhoff M, Jackson S, Issa N, Dunn T, Matas A, Ibrahim H. Frequency of Blood Transfusion Episodes after Kidney Transplantation Is Associated with Development of Class II Donor Specific Antibodies [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/frequency-of-blood-transfusion-episodes-after-kidney-transplantation-is-associated-with-development-of-class-ii-donor-specific-antibodies/. Accessed May 16, 2021.

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