Blood transfusion and the risk for infections in kidney transplant patients.

<h4>Background</h4>Receipt of a red blood cell transfusion (RBCT) post-kidney transplantation may alter immunity which could predispose to subsequent infection.<h4>Methods</h4>We carried out a single-center, retrospective cohort study of 1,258 adult kidney transplant recipien...

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Autores principales:	David Massicotte-Azarniouch, Manish M Sood, Dean A Fergusson, Michaël Chassé, Alan Tinmouth, Greg A Knoll
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/886993ea0d924676bb1d3cb7588df433
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spelling	oai:doaj.org-article:886993ea0d924676bb1d3cb7588df4332021-12-02T20:13:15ZBlood transfusion and the risk for infections in kidney transplant patients.1932-620310.1371/journal.pone.0259270https://doaj.org/article/886993ea0d924676bb1d3cb7588df4332021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259270https://doaj.org/toc/1932-6203<h4>Background</h4>Receipt of a red blood cell transfusion (RBCT) post-kidney transplantation may alter immunity which could predispose to subsequent infection.<h4>Methods</h4>We carried out a single-center, retrospective cohort study of 1,258 adult kidney transplant recipients from 2002 to 2018 (mean age 52, 64% male). The receipt of RBCT post-transplant (468 participants transfused, total 2,373 RBCT) was analyzed as a time-varying, cumulative exposure. Adjusted cox proportional hazards models were used to calculate hazard ratios (HR) for outcomes of bacterial or viral (BK or CMV) infection.<h4>Results</h4>Over a median follow-up of 3.8 years, bacterial infection occurred in 34% of participants at a median of 409 days post-transplant and viral infection occurred in 25% at a median of 154 days post-transplant. Transfusion was associated with a step-wise higher risk of bacterial infection (HR 1.35, 95%CI 0.95-1.91; HR 1.29, 95%CI 0.92-1.82; HR 2.63, 95%CI 1.94-3.56; HR 3.38, 95%CI 2.30-4.95, for 1, 2, 3-5 and >5 RBCT respectively), but not viral infection. These findings were consistent in multiple additional analyses, including accounting for reverse causality.<h4>Conclusion</h4>Blood transfusion after kidney transplant is associated with a higher risk for bacterial infection, emphasizing the need to use transfusions judiciously in this population already at risk for infections.David Massicotte-AzarniouchManish M SoodDean A FergussonMichaël ChasséAlan TinmouthGreg A KnollPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0259270 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David Massicotte-Azarniouch Manish M Sood Dean A Fergusson Michaël Chassé Alan Tinmouth Greg A Knoll Blood transfusion and the risk for infections in kidney transplant patients.
description	<h4>Background</h4>Receipt of a red blood cell transfusion (RBCT) post-kidney transplantation may alter immunity which could predispose to subsequent infection.<h4>Methods</h4>We carried out a single-center, retrospective cohort study of 1,258 adult kidney transplant recipients from 2002 to 2018 (mean age 52, 64% male). The receipt of RBCT post-transplant (468 participants transfused, total 2,373 RBCT) was analyzed as a time-varying, cumulative exposure. Adjusted cox proportional hazards models were used to calculate hazard ratios (HR) for outcomes of bacterial or viral (BK or CMV) infection.<h4>Results</h4>Over a median follow-up of 3.8 years, bacterial infection occurred in 34% of participants at a median of 409 days post-transplant and viral infection occurred in 25% at a median of 154 days post-transplant. Transfusion was associated with a step-wise higher risk of bacterial infection (HR 1.35, 95%CI 0.95-1.91; HR 1.29, 95%CI 0.92-1.82; HR 2.63, 95%CI 1.94-3.56; HR 3.38, 95%CI 2.30-4.95, for 1, 2, 3-5 and >5 RBCT respectively), but not viral infection. These findings were consistent in multiple additional analyses, including accounting for reverse causality.<h4>Conclusion</h4>Blood transfusion after kidney transplant is associated with a higher risk for bacterial infection, emphasizing the need to use transfusions judiciously in this population already at risk for infections.
format	article
author	David Massicotte-Azarniouch Manish M Sood Dean A Fergusson Michaël Chassé Alan Tinmouth Greg A Knoll
author_facet	David Massicotte-Azarniouch Manish M Sood Dean A Fergusson Michaël Chassé Alan Tinmouth Greg A Knoll
author_sort	David Massicotte-Azarniouch
title	Blood transfusion and the risk for infections in kidney transplant patients.
title_short	Blood transfusion and the risk for infections in kidney transplant patients.
title_full	Blood transfusion and the risk for infections in kidney transplant patients.
title_fullStr	Blood transfusion and the risk for infections in kidney transplant patients.
title_full_unstemmed	Blood transfusion and the risk for infections in kidney transplant patients.
title_sort	blood transfusion and the risk for infections in kidney transplant patients.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/886993ea0d924676bb1d3cb7588df433
work_keys_str_mv	AT davidmassicotteazarniouch bloodtransfusionandtheriskforinfectionsinkidneytransplantpatients AT manishmsood bloodtransfusionandtheriskforinfectionsinkidneytransplantpatients AT deanafergusson bloodtransfusionandtheriskforinfectionsinkidneytransplantpatients AT michaelchasse bloodtransfusionandtheriskforinfectionsinkidneytransplantpatients AT alantinmouth bloodtransfusionandtheriskforinfectionsinkidneytransplantpatients AT gregaknoll bloodtransfusionandtheriskforinfectionsinkidneytransplantpatients
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Blood transfusion and the risk for infections in kidney transplant patients.

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