Adverse effect of blood transfusion on the long-term outcome of kidney transplantation.

In 116 patients treated with azathioprine and prednisolone, 2-year patient survival and primary renal allograft survival was analyzed with regard to the effects of pretransplant blood transfusion and of matching for HLA-A, HLA-B, and HLA-DR. Two years after transplantation, patient survival was significantly lower in transfused patients than in non-transfused patients (81 vs. 97%, p less than 0.05). A detrimental effect of blood transfusion on graft survival was found in conjunction with HLA-A compatibility (p = 0.01 overall, and p = 0.003 for HLA-B mismatched transplants). Among transfused patients, enhanced graft survival was associated with incompatibility for HLA-A (p = 0.02 overall, and p = 0.008 for HLA-B mismatched transplants), and with compatibility for HLA-B (p = 0.0006 overall, and p = 0.005 for HLA-A mismatched transplants). The present results indicate that blood transfusion may have detrimental effect on patient survival.