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An update on the impact of pre-transplant transfusions and allosensitization on time to renal transplant and on allograf...

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Material Information

Title:
An update on the impact of pre-transplant transfusions and allosensitization on time to renal transplant and on allograft survival
Physical Description:
Mixed Material
Language:
English
Creator:
Scornik, Juan C.
Bromberg, Jonathan S.
Norman, Douglas J.
Bhanderi, Mayank
Gitlin, Matthew
Petersen, Jeffrey
Publisher:
Bio-Med Central (BMC Nephrology)
Publication Date:

Notes

Abstract:
Background: Blood transfusions have the potential to improve graft survival, induce sensitization, and transmit infections. Current clinical practice is to minimize transfusions in renal transplantation candidates, but it is unclear if the evidence continues to support pre-transplant transfusion avoidance. Changes in the Medicare prospective payment system may increase transfusion rates. Thus there is a need to re-evaluate the literature to improve the management options for renal transplant candidates. Methods: A review applying a systematic approach and conducted using MEDLINE®, Embase®, and the Cochrane Library for English-language publications (timeframe: 01/1984–03/2011) captured 180 studies and data from publically available registries and assessed the impact of transfusions on allosensitization and graft survival, and the impact of allosensitization on graft survival and wait time. Results: Blood transfusions continued to be a major cause of allosensitization, with allosensitization associated with increased rejection and graft loss, and longer wait times to transplantation. Although older studies showed a beneficial effect of transfusion on graft survival, this benefit has largely disappeared in the post-cyclosporine era due to improved graft outcomes with current practice. Recent data suggested that it may be the donor-specific antibody component of allosensitization that carried the risk to graft outcomes. Conclusions: Results of this review indicated that avoiding transfusions whenever possible is a sound management option that could prevent detrimental effects in patients awaiting kidney transplantation. Keywords: Transfusion, Allosensitization, Renal transplant, Graft survival
General Note:
Scornik et al. BMC Nephrology 2013, 14:217 http://www.biomedcentral.com/1471-2369/14/217; Pages 1-12
General Note:
doi:10.1186/1471-2369-14-217 Cite this article as: Scornik et al.: An update on the impact of pretransplant transfusions and allosensitization on time to renal transplant and on allograft survival. BMC Nephrology 2013 14:217.

Record Information

Source Institution:
University of Florida
Holding Location:
University of Florida
Rights Management:
All rights reserved by the source institution.
Resource Identifier:
oclc -
System ID:
AA00019199:00001

  • STANDARD VIEW
  • MARC VIEW

Material Information

Title:
An update on the impact of pre-transplant transfusions and allosensitization on time to renal transplant and on allograft survival
Physical Description:
Mixed Material
Language:
English
Creator:
Scornik, Juan C.
Bromberg, Jonathan S.
Norman, Douglas J.
Bhanderi, Mayank
Gitlin, Matthew
Petersen, Jeffrey
Publisher:
Bio-Med Central (BMC Nephrology)
Publication Date:

Notes

Abstract:
Background: Blood transfusions have the potential to improve graft survival, induce sensitization, and transmit infections. Current clinical practice is to minimize transfusions in renal transplantation candidates, but it is unclear if the evidence continues to support pre-transplant transfusion avoidance. Changes in the Medicare prospective payment system may increase transfusion rates. Thus there is a need to re-evaluate the literature to improve the management options for renal transplant candidates. Methods: A review applying a systematic approach and conducted using MEDLINE®, Embase®, and the Cochrane Library for English-language publications (timeframe: 01/1984–03/2011) captured 180 studies and data from publically available registries and assessed the impact of transfusions on allosensitization and graft survival, and the impact of allosensitization on graft survival and wait time. Results: Blood transfusions continued to be a major cause of allosensitization, with allosensitization associated with increased rejection and graft loss, and longer wait times to transplantation. Although older studies showed a beneficial effect of transfusion on graft survival, this benefit has largely disappeared in the post-cyclosporine era due to improved graft outcomes with current practice. Recent data suggested that it may be the donor-specific antibody component of allosensitization that carried the risk to graft outcomes. Conclusions: Results of this review indicated that avoiding transfusions whenever possible is a sound management option that could prevent detrimental effects in patients awaiting kidney transplantation. Keywords: Transfusion, Allosensitization, Renal transplant, Graft survival
General Note:
Scornik et al. BMC Nephrology 2013, 14:217 http://www.biomedcentral.com/1471-2369/14/217; Pages 1-12
General Note:
doi:10.1186/1471-2369-14-217 Cite this article as: Scornik et al.: An update on the impact of pretransplant transfusions and allosensitization on time to renal transplant and on allograft survival. BMC Nephrology 2013 14:217.

Record Information

Source Institution:
University of Florida
Holding Location:
University of Florida
Rights Management:
All rights reserved by the source institution.
Resource Identifier:
oclc -
System ID:
AA00019199:00001