Abstract
The impact of a systematic, nondonor-specific, pregraft blood transfusion (BT) protocol was evaluated retrospectively in 446 consecutive, first renal transplant recipients with regard to graft survival rate, rejection, and incidence of infectious episodes. Cyclosporin A was the maintenance immunosuppressive treatment in all patients after a 2-week course of antithymocyte globulin or anti-IL-2 monoclonal antibody. Recipients were assigned to three groups according to the number of pregraft BT (one or two, three or four, or more than four). When nonimmunological failures were excluded from the study, patients receiving three or four BT had statistically better graft survival (P<0.02) and a lower incidence of rejection episodes (P<0.05) than those in the other groups. There were no significant differences between the three groups in the distribution of HLA mismatching (A, B and DR), time interval between the last BT and transplantation, DR6 recipient phenotype, or nonimmunological failures. Our results show that the number of pregraft BT is an important factor in transplantation.
Similar content being viewed by others
References
Bignon JD, Le Forestier M, Hourmant M, Klaussmann G, Soulillou JP (1985) Prevalence in risk factors of hyperimmunization in patients awaiting grafts. Effect of grafting through a positive B-lymphocyte cross-match. In: Touraine JL, Traeger J (eds) Transplantation and clinical immunology, vol 17. Excerpta Medica, Amsterdam, pp 57–69
Blumberg N, Heal J, Murphy P (1986) Association between transfusion of whole blood and cancer recurrence. Br Med J 293: 530–532
Bonneville M, Carcagne J, Vié H, Moreau JF, Chevalier S, Latour M, Carosella E, Soulillou JP (1989) Polyclonal rabbit gammaglobulins against a human cytotoxic CD4+ T cell clone. I. Clone characteristics and antiblast globulin (GAB) preparation. Transplantation 48: 253–260
Brynger H, Persson H, Flatmark A, Albrechtsen D, Frödin L, Tufvesson G, Gäbel H, Weibull H, Möller E, Lundgren G, Groth CG (1988) No effect of blood transfusions or HLA matching on renal graft success rate in recipients treated with cyclosporineprednisolone or cyclosporine-Azathioprine-prednisolone: the Scandinavian experience. Transplant Proc 20: 261–263
Carpenter CB, d'Apice AJF, Abbas AK (1976) The role of antibodies in the rejection and enhancement of organ allograft. Adv Immunol 2: 1–36
Cecka JM, Cicciarelli J, Mickey MR, Terasaki PI (1988) Blood transfusions and HLA matching. An either/or situation in cadaveric renal transplantation. Transplantation 45: 81–86
Chou S, Kim DY, Norman DJ (1987) Transmission of CMV by pretransplantation blood transfusion in renal transplantation candidate. J Infect Dis 155: 565–567
Es AA van, Marquet RL, Rood JJ van, Kalff MW, Balner H (1977) Blood transfusions induce prolonged kidney allograft survival in rhesus monkey. Lancet I: 506–508
Festenstein H, Sachs JA, Paris AMI, Pegrom GD (1976) Influence of HLA matching and blood transfusion on outcome of 502 London transplant group renal-graft recipients. Lancet I: 157–161
Hourmant M, Soulillou JP, Bui-Quang D, Guenel J (1979) The beneficial effect of blood transfusions: role of the time interval between the last transfusion and the transplantation Transplantation 28: 40–44
Hourmant M, Babinet F, Cantarovich D, Latour M, Carcagne J, Vié H, Bonneville M, Moreau JF, Carosella E, Soulillou JP (1989) Polyclonal rabbit gammaglobulins against a human cytotoxic CD4+T cell clone. II. Use in prevention of rejection in kidney transplantation: a pilot study. Transplantation 48: 260–263
Hourmant M, Taupin JL, Leymerigie F, Cantarovich D, Soulillou JP (1989) Azathioprine — cyclosporin A (CyA) double therapy versus CyA alone after the first rejection episode in kidneytransplanted patients under CyA. A randomized study. Transplant Int 2: 113–116
Iwaki Y, Cecka JM, Terasaki PI (1990) The transfusion effect in cadaveric kidney transplants — yes or no. Transplantation 49: 56–59
Kerman RH, Buren CT van, Lewis RM, Kahan BD (1988) Impact of blood transfusions and HLA on cyclosporine-treated renal transplant recipients. Transplant Proc 20: 264–269
Kerman RH, Buren CT van, Lewis RM, Kahan BD (1988) Successful transplantation of 100 untransfused cyclosporine-treated primary recipients of cadaveric renal allografts. Transplantation 45: 37–40
Marquet RL, Heysteck GA, Tinbergen WJ (1971) Specific inhibition of organ allograft rejection by donor blood. Transplant Proc 3: 708–711
Melzer JS, Husing RM, Feduska NJ, Tomlanovich SJ, Vincenti F, Amend WJC, Garovoy M, Salvatierra O Jr (1987) The beneficial effect of pretransplant blood transfusions in cyclosporine-treated cadaveric renal allograft recipients. Transplantation 43: 61–64
Muller JY, Kaplan C, Betuel H, Bignon JD, Fauchet R, Gluckman JC, Soulillou JP, Thibault P (1982) Effet des transfusions sanguines sur les greffes de rein. Nouv Presse Med 11: 3697–3701
Muller JY, Kaplan C, Cartron J (1982) Rapport de l'enquête Transfusion-Transplantation. Rev Fr Transfus Immunohematol 3: 327–352
Opelz G for the Collaborative Transplant Study (1987) Improved kidney graft survival in nontransfused recipients. Transplant Proc 19: 149–152
Opelz G, Terasaki PI (1976) Prolongation effect on blood transfusions of kidney graft survival. Transplantation 22: 380–382
Sanfilippo F, Vaughn WK, Bollinger RR, Spees EK (1984) The influence of pretransplant transfusions, using different blood products, on patient sensitization and renal allograft survival. Transplantation 37: 350–356
Soulillou JP, Bignon JD, Peyrat MA, Guimbretière J, Guenel J (1980) Systematic transfusions in hemodialysed patients awaiting grafts. Kinetics of anti-T and B lymphocyte immunization and its incidence of graft function. Transplantation 30: 285–289
Soulillou JP, Blandin F, Gunther E, Lemoine V (1984) Blood transfusion effect on heart allograft in rats. Studies on the role of the RT1 subregions. Transplantation 38: 63–67
Soulillou JP, Peyronnet P, Le Mauff B, Boeffard F, Godard A, Soulillou JP (1987) Prevention of rejection of kidney transplants by monoclonal antibody directed against interleukin 2 receptor. Lancet I: 1339–1342
Soulillou JP, Cantarovich D, Le Mauff B, Giral M, Hourmant M, Hirn M, Jacques Y (1990) Randomized trial of an anti-interleukin 2 receptor monoclonal antibody (33B3.1) versus rabbit antithymocyte globulin (ATG) in prophylaxis of early rejection in human renal transplantation. N Engl J Med 322: 1175–1182
Author information
Authors and Affiliations
About this article
Cite this article
Baatard, R., Dantal, J., Hourmant, M. et al. Effect of the number of pregraft blood transfusions in kidney graft recipients treated with bioreagents and cyclosporin A. Transplant Int 4, 235–238 (1991). https://doi.org/10.1007/BF00649110
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00649110