PMID- 24009295
OWN - NLM
STAT- MEDLINE
DCOM- 20141028
LR  - 20220311
IS  - 1460-2385 (Electronic)
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 28
IP  - 11
DP  - 2013 Nov
TI  - Sensitization from transfusion in patients awaiting primary kidney transplant.
PG  - 2908-18
LID - 10.1093/ndt/gft362 [doi]
AB  - BACKGROUND: Sensitization to human leukocyte antigen (HLA) from red blood cell 
      (RBC) transfusion is poorly quantified and is based on outdated, insensitive 
      methods. The objective was to evaluate the effect of transfusion on the breadth, 
      magnitude and specificity of HLA antibody formation using sensitive and specific 
      methods. METHODS: Transfusion, demographic and clinical data from the US Renal 
      Data System were obtained for patients on dialysis awaiting primary kidney 
      transplant who had >/= 2 HLA antibody measurements using the Luminex single-antigen 
      bead assay. One cohort included patients with a transfusion (n = 50) between two 
      antibody measurements matched with up to four nontransfused patients (n = 155) by 
      age, sex, race and vintage (time on dialysis). A second crossover cohort (n = 25) 
      included patients with multiple antibody measurements before and after 
      transfusion. We studied changes in HLA antibody mean fluorescence intensity (MFI) 
      and calculated panel reactive antibody (cPRA). RESULTS: In the matched cohort, 10 
      of 50 (20%) transfused versus 6 of 155 (4%) nontransfused patients had a >/= 10 HLA 
      antibodies increase of >3000 MFI (P = 0.0006); 6 of 50 (12%) transfused patients 
      had a >/= 30 antibodies increase (P = 0.0007). In the crossover cohort, the number 
      of HLA antibodies increasing >1000 and >3000 MFI was higher in the transfused 
      versus the control period, P = 0.03 and P = 0.008, respectively. Using a >/= 3000 
      MFI threshold, cPRA significantly increased in both matched (P = 0.01) and 
      crossover (P = 0.002) transfused patients. CONCLUSIONS: Among prospective primary 
      kidney transplant recipients, RBC transfusion results in clinically significant 
      increases in HLA antibody strength and breadth, which adversely affect the 
      opportunity for future transplant.
FAU - Yabu, Julie M
AU  - Yabu JM
AD  - Division of Nephrology, Department of Medicine, Stanford University, Stanford, 
      CA, USA.
FAU - Anderson, Matthew W
AU  - Anderson MW
FAU - Kim, Deborah
AU  - Kim D
FAU - Bradbury, Brian D
AU  - Bradbury BD
FAU - Lou, Calvin D
AU  - Lou CD
FAU - Petersen, Jeffrey
AU  - Petersen J
FAU - Rossert, Jerome
AU  - Rossert J
FAU - Chertow, Glenn M
AU  - Chertow GM
FAU - Tyan, Dolly B
AU  - Tyan DB
LA  - eng
GR  - K23AI104401/AI/NIAID NIH HHS/United States
GR  - K23 AI104401/AI/NIAID NIH HHS/United States
GR  - K24DK54488/DK/NIDDK NIH HHS/United States
GR  - R37 DK054488/DK/NIDDK NIH HHS/United States
GR  - R01 DK054488/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20130905
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Antibodies/*blood/immunology
MH  - Antibody Formation/*immunology
MH  - *Blood Transfusion
MH  - Cross-Over Studies
MH  - Female
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Kidney Failure, Chronic/blood/*immunology/surgery
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Renal Dialysis
MH  - Waiting Lists
PMC - PMC3811060
OTO - NOTNLM
OT  - HLA antibody
OT  - calculated panel reactive antibody
OT  - kidney transplantation
OT  - sensitization
OT  - transfusion
EDAT- 2013/09/07 06:00
MHDA- 2014/10/29 06:00
PMCR- 2014/11/01
CRDT- 2013/09/07 06:00
PHST- 2013/09/07 06:00 [entrez]
PHST- 2013/09/07 06:00 [pubmed]
PHST- 2014/10/29 06:00 [medline]
PHST- 2014/11/01 00:00 [pmc-release]
AID - gft362 [pii]
AID - 10.1093/ndt/gft362 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2013 Nov;28(11):2908-18. doi: 10.1093/ndt/gft362. Epub 
      2013 Sep 5.