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Effect of blood product transfusion-induced tolerance on incidence of cardiac allograft rejection.

Abstract：

BACKGROUND:Blood product transfusion has been successfully used in solid-organ transplantation to induce tolerance. Whether a similar protective effect of blood product transfusion exists in heart transplantation is controversial. OBJECTIVE:To investigate the effect of cellular blood product transfusion within 2 weeks posttransplantation on the incidence of cellular and antibody-mediated rejection. PATIENTS AND METHODS:Patients were grouped on the basis of number of blood transfusions; group 1 received no transfusions, and groups 2, 3, and 4 each received an incremental number of transfusion units. All endomyocardial biopsy samples were routinely studied using immunofluorescence in the first 12 weeks posttransplantation. RESULTS:Baseline characteristics including age, sex, body mass index, history of diabetes, donor characteristics, and pretransplantation laboratory values were similar except that group 4 had a higher rate of previous sternotomy and longer ischemic time during transplantation. Approximately 9200 endomyocardial biopsy samples composed the data. Short- and long-term freedom from the International Society for Heart & Lung Transplantation grade 3A or higher cellular rejection and from antibody-mediated rejection were comparable between groups. CONCLUSIONS:Blood transfusions within the first 2 weeks post-transplantation do not seem to confer any protective effect against posttransplantation cellular rejection or antibody- mediated rejection. Whether other unmeasured confounding factors mask their effect requires further prospective studies.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Kotter JR,Drakos SG,Horne BD,Hammond EH,Stehlik J,Bull DA,Reid BB,Gilbert EM,Everitt M,Alharethi R,Budge D,Verma DR,Li DY,Kfoury AG

doi

10.1016/j.transproceed.2010.05.167

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

2687-92

issue

7

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(10)00956-5

journal_volume

42

pub_type

杂志文章

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