Perioperative Blood Transfusion Significantly Increases Inpatient Morbidity and Mortality in Renal Transplant Recipients: 15-year Experience

K. Mahendraraj¹, G. Medrano del Rosal¹, M. Kruse¹, R. Shah¹, T. Katsichtis¹, T. Brennan², N. Nissen², T. Todo², K. Kosari², A. Klein², I. Kim²

¹Surgery, Lincoln Medical Center, New York, NY, ²Transplant Surgery, Cedars-Sinai Medical Center, Los Angeles, CA

Meeting: 2019 American Transplant Congress

Abstract number: D391

Keywords: Blood transfusion, Morbidity, Post-operative complications, Rejection

Session Information

Session Name: Poster Session D: Late Breaking

Session Type: Poster Session

Date: Tuesday, June 4, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: This study evaluates the immediate effects of perioperative blood transfusion (PBT) on inpatient morbidity and mortality among renal transplant (RT) recipients during their index hospitalization following surgery.

*Methods: 30,059 RT patients were abstracted from the National Inpatient Sample database over a 15-year period (2001-2015). PBT was defined as blood transfusion administered at any time during index admission.

*Results: Among 30,059 RT patients, 5,579 (18.6%) had PBT. A greater proportion of PBT patients were older than age 60, female, were non-elective admissions, had more cardiovascular and pulmonary comorbidities, and were more likely to receive a cadaveric graft. 13% PBT patients sustained intraoperative hemorrhage. PBT led to longer length of stay (LOS), greater hospitalization cost, higher rates of renal failure, sepsis, myocardial infarction, graft vascular thrombosis, acute rejection and delayed graft function (DGF), p<0.01. Intraoperative hemorrhage (OR 3.0), LOS>1 week (OR 2.0), acute rejection/DGF (OR 1.1), coronary artery disease (CAD) (OR 1.2), cadaveric graft (OR 1.4) and chronic anemia (OR 1.4) were risk factors for receiving PBT, p<0.01. PBT was identified as an independent risk factor for inpatient mortality (OR 1.6, p<0.01).

*Conclusions: These results suggest that PBT is a primary cause of allosensitization, leading to significantly higher inpatient morbidity and mortality among RT patients. Intraoperative hemorrhage, CAD, chronic anemia and cadaveric grafts were the greatest risk factors for PBT. Close postoperative monitoring of these patients during hospitalization is paramount to circumvent adverse outcomes.

To cite this abstract in AMA style:

Mahendraraj K, Rosal GMedranodel, Kruse M, Shah R, Katsichtis T, Brennan T, Nissen N, Todo T, Kosari K, Klein A, Kim I. Perioperative Blood Transfusion Significantly Increases Inpatient Morbidity and Mortality in Renal Transplant Recipients: 15-year Experience [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/perioperative-blood-transfusion-significantly-increases-inpatient-morbidity-and-mortality-in-renal-transplant-recipients-15-year-experience/. Accessed May 18, 2025.

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