Blood transfusions in liver recipients: A conundrum or a clear benefit in the cyclosporine/tacrolimus era?

Baburao Koneru, David Harrison, Mohammed Rizwan, Bart K. Holland, Tobi Ippolito, Michael J. Holman, Carroll B. Leevy

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Blood transfusions are common in patients with end-stage liver disease (ESLD), and their effects on sensitization, rejection, and liver graft survival are not well known. These effects were examined in 121 recipients of primary liver grafts, surviving ≤30 days. Ninety-six (79%) patients received transfusions before transplantation. Transfusion recipients had significantly fewer severe or recurrent rejection episodes (18%), compared with patients who did not receive transfusions (42%, P=0.006), if the first transfusion was ≤90 days before the transplant. Patients with alcoholic ESLD (n=49) had significantly fewer severe rejection episodes when compared with the nonalcoholic (n=72) patients (12% vs. 35%, P=0.004). The transfusion benefit was, however, more apparent and significant in the nonalcoholic (26% vs. 56% in non-transfused, P=0.02) than among the alcoholic recipients (6% vs. 25%, P=0.1). This finding is, most likely, due to a combination of a higher rate of severe rejection and the statistical power of the larger number of recipients in the nonalcoholic group. This finding is further corroborated by a multivariate analysis in which blood transfusions retained their benefit (P<0.05) independent of recipient's age and diagnosis. Graft and patient survival were not significantly different in the transfused versus nontransfused groups. Transfusion recipients had a higher panel antibody (11.4±23.4 vs. 2.7±8.1, P<0.02) but no increased risk of a positive crossmatch. In liver recipients, blood transfusions diminish the risk of rejection independent of recipient's age and the cause of ESLD.

Original languageEnglish (US)
Pages (from-to)1587-1590
Number of pages4
Issue number11
StatePublished - Jun 15 1997

All Science Journal Classification (ASJC) codes

  • Transplantation


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