The Risks Associated with Blood Transfusions in Kidney Transplant Recipients: A Retrospective Cohort Study Using Health Administrative Data
1Medicine, University of Ottawa, Ottawa Hospital, Ottawa, ON, Canada, 2Medicine, University of Ottawa, Ottawa Hospital Research Insitute, Ottawa, ON, Canada, 3Clinical Epidemiology, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada, 4Medicine, University of Montreal, Montreal, QC, Canada, 5Hematology, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada, 6Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada
Meeting: 2020 American Transplant Congress
Abstract number: D-048
Keywords: Blood transfusion, Infection, Kidney transplantation, Outcome
Session Information
Session Name: Poster Session D: Kidney Complications: Immune Mediated Late Graft Failure
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Red blood cell transfusion (RBCT) is a common occurrence in kidney transplant recipients, however it may carry certain risks which could be detrimental to the these patients. The aim of this study is to examine the risks associated with post-transplant RBCT in kidney transplant recipients.
*Methods: This is a retrospective cohort study of all adult kidney transplant recipients at our centre, from 2002 to 2018. The exposure of interest is receipt of RBCT after kidney transplant. The outcomes are graft rejection, graft loss, death censored graft loss, any infection and venous thromboembolic events (VTE). Manual chart review and health administrative databases were used to ascertain baseline characteristics, exposure and outcomes. A time-to-event analysis was done with hazard ratios (HR) calculated using Cox proportional hazards model with RBCT as a time-varying, cumulative exposure.
*Results: There were 1,258 kidney transplants during the study period. In all, 468 transplant recipients received a total of 2,373 RBCT after transplant (incidence of 33 RBCT per 100 patient-year of follow-up). The cumulative incidence of any rejection, graft loss, death-censored graft loss, any infection, viral infection and VTE was 21.5%, 62.9%, 25.6%, 60.7%, 28.2% and 16.0% respectively during the study period. For every 1 unit of blood transfused, the adjusted HR (95% CI) for rejection was 1.06 (1.01 to 1.11); graft loss 1.15 (1.13 to 1.17); death-censored graft loss 1.13 (1.10 to 1.16); any infection 1.13 (1.11 to 1.16); viral infection 1.13 (1.01 to 1.25); VTE 1.12 (1.07 to 1.17).
*Conclusions: The receipt of a RBCT after kidney transplant is associated with an increased risk for adverse outcomes, including rejection, infection, VTE and graft loss. The results from this study suggest that clinicians caring for kidney transplant recipients should carefully consider the potential serious risks associated with RBCT in these patients and be even more judicious in their use of RBCT.
| No. of events (%) | Cumulative incidence | Adjusted HR (95% CI) | |
| Any rejection | 197 (15.7) | 21.5% | 1.06 (1.01 to 1.11) |
| Graft loss | 318 (25.3) | 62.9% | 1.15 (1.13 to 1.17) |
| Death-censored graft loss | 114 (9.1) | 25.6% | 1.13 (1.10 to 1.16) |
| Any infection | 456 (36.3) | 60.7% | 1.13 (1.11 to 1.16) |
| Viral infection (BK or CMV) | 105 (23.2) | 50.3% | 1.13 (1.01 to 1.25) |
| VTE | 79 (6.3) | 16.0% | 1.12 (1.07 to 1.17) |
To cite this abstract in AMA style:
Massicotte-Azarniouch D, Sood M, Fergusson D, Chassé M, Tinmouth A, Knoll G. The Risks Associated with Blood Transfusions in Kidney Transplant Recipients: A Retrospective Cohort Study Using Health Administrative Data [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-risks-associated-with-blood-transfusions-in-kidney-transplant-recipients-a-retrospective-cohort-study-using-health-administrative-data/. Accessed May 14, 2025.« Back to 2020 American Transplant Congress