Retrospective Study
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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jun 18, 2023; 13(4): 157-168
Published online Jun 18, 2023. doi: 10.5500/wjt.v13.i4.157
Table 1 Baseline characteristics of both the transfusion and non-transfusion groups, n (%)
Total cohort, 105 Non-transfusion, 51 (48.6%) Transfusion, 54 (51.4%) P valueAge (mean ± SD) 39.7 ± 14.5 40.5 ± 13.9 38.9 ± 15.1 0.583 Gender Female 28 (26.7) 10 (19.6) 18 (33.3) 0.127 Male 77 (73.3) 41 (80.4) 36 (66.7) Type of transplantation LRKTx 84 (80) 43 (84.3) 41 (75.9) 0.566 LURKTx 15 (14.3) 6 (11.8) 9 (16.7) DDKTx 6 (5.7) 2 (3.9) 4 (7.4) HLA mismatch 3 (1-4) 3 (0-4) 3 (2-4) 0.152 Cause of ESRD Diabetes 18 (17.1) 7 (13.7) 11 (20.4) 0.331 GN 26 (24.8) 11 (21.6) 15 (27.8) Hypertension 18 (17.1) 12 (23.5) 6 (11.1) PCKD 1 (1) 1 (2) 0 (0) Urological 7 (6.7) 2 (3.9) 5 (9.3) Other 35 (33.3) 18 (35.3) 17 (31.5) Donor's age 33 ± 8.6 32.4 ± 8.4 33.5 ± 8.8 0.562 Induction therapy ATG 42 (40) 21 (41.2) 21 (38.9) 1 Basiliximab 62 (59) 30 (58.8) 32 (59.3) No induction 1 (1) 0 (0) 1 (1.9) Maintenance immunosuppression CNI used tacrolimus 105 (100) 51 (100) 54 (100) Average CNI level 7 (6-8) 7 (6-8) 7 (6-8) 0.743 Antimetabolite used (MMF) 105 (100) 51 (100) 54 (100)
Table 2 Blood transfusion information
Total, 105 Non-transfused, 51 (48.6%) Transfused, 54 (51.4%) P valueHemoglobin at transplantation 10.5 ± 1.7 11.2 ± 1.6 9.8 ± 1.6 < 0.001 Hemoglobin at blood transfusion 7.4 ± 0.9 Hemoglobin after transfusion 9.2 ± 1.1 Number of blood transfusion units given 1 (0-1.5) 1 (0-1.5)
Table 3 Infectious and non-infectious complications among the two groups, n (%)
Total, 105 Non-transfusion, 51 (48.6%) Transfusion, 54 (51.4%) P valueNo. of infections 0 (0-1) 1 (0-1) 0 (0-1.25) 0.554 Types of infections none 55 (52.4) 25 (49) 30 (55.6) 0.745 UTI 30 (28.6) 14 (27.5) 16 (29.6) 0.832 Pnemonia 1 (1) 1 (2) 0 (0) 0.486 TB 1 (1) 0 (0) 1 (1.9) 1 BK 7 (6.7) 5 (9.8) 2 (3.7) 0.261 Bactremia 4 (3.8) 1 (2) 3 (5.6) 0.618 Epidediymo-orchitis 2 (1.9) 1 (2) 1 (1.9) 1 Gastroenteritis 2 (1.9) 2 (3.9) 0 (0) 0.234 Herpes zoster 1 (1) 0 (0) 1 (1.9) 1 Infected AVF 1 (1) 1 (2) 0 (0) 0.486 Perianal abcess 1 (1) 1 (2) 0 (0) 0.486 COVID-19 9 (8.6) 6 (11.8) 3 (5.6) 0.311 URTI 2 (1.9) 1 (2) 1 (1.9) 1 CMV 12 (11.4) 6 (11.8) 6 (11.1) 1 Urological complications None 95 (90.5) 49 (96.1) 46 (85.2) 0.484 Allograft artery stenosis 1 (1) 0 (0) 1 (1.9) Collection 3 (2.9) 1 (2) 2 (3.7) Lymphocele 1 (1) 0 (0) 1 (1.9) Obstrctive uropathy 1 (1) 0 (0) 1 (1.9) Perinephric collection and ureteric stricture 2 (1.9) 0 (0) 2 (3.7) Unrogenic bladder 1 (1) 0 (0) 1 (1.9) Urinary leak 1 (1) 1 (2) 0 (0) Urological complications No 95 (90.5) 49 (96.1) 46 (85.2) 0.094 Yes 10 (9.5) 2 (3.9) 8 (14.8) CNI withdrawal 1 (1) 0 (0) 1 (1.9) 1 Duration from Tx 3 d MMF withdrawal 1 (1) 0 (0) 1 (1.9) 1 Duration from Tx 3 d Steroids withdrawal 0 (0) 0 (0) 0 (0)
Table 4 Comparison in Outcomes of transplantation between the two groups, n (%)
Total, 105 Non-transfusion, 51 (48.6%) Transfusion, 54 (51.4%) P valueRejection 5 (4.8) 2 (3.9) 3 (5.6) 1 Rejection type ABMR 2 (40) 1 (50) 1 (33.3) 1 Cellular 3 (60) 1 (50) 2 (66.7) Graft loss 4 (3.8) 1 (2) 3 (5.6) 0.618 Death 2 (1.9) 1 (2) 1 (1.9) 1 DGF 11 (10.5) 2 (3.9) 9 (16.7) 0.053 Serum creatinine At discharge 141 ± 124.1 123 ± 56.7 158 ± 163 0.770 6 mo 108 ± 40.7 107.1 ± 28 108.9 ± 50.4 0.825 12 mo 109.1 ± 51.3 101.9 ± 22.9 117 ± 69.8 0.182 18 mo 126 ± 168.7 106.2 ± 26.5 147.4 ± 241.5 0.735 Creatinine difference: At 18 mo-at discharge -19.4 ± 61.5 12.3 ± 253.8 0.439
Table 5 Characteristics of rejection developers vs non-rejection developers among the study cohort, n (%)
Non-rejection, 100 Rejection, 5 P valueAge (mean ± SD) 36.5 (28.25-51.75) 36 (21-46.5) 0.383 Gender Female 28 (28) 0 (0) 0.321 Male 72 (72) 5 (100) Type of transplantation LRKTx 81 (81) 3 (60) 0.172 LURKTx 13 (13) 2 (40) DDKTx 6 (6) 0 (0) HLA mismatch 3 (1-4) 3 (1-4) 0.729 Cause of ESRD Diabetes 18 (18) 0 (0) 0.199 GN 23 (23) 3 (60) Hypertension 18 (18) 0 (0) PCKD 1 (1) 0 (0) Urological 6 (6) 1 (20) Other 34 (34) 1 (20) Donor's age 32 (26-39) 28 (25.5-43.5) 0.981 Induction therapy ATG 41 (41) 1 (20) 0.438 Basiliximab 58 (58) 4 (80) No induction 1 (1) 0 (0) Average CNI level 7 (6-8) 8 (6.5-9) 0.311 Hb at transplantation 10.65 (9.025-11.3) 10.7 (9.05-12.45) 0.792 Hb at blood transfusion 7.4 (6.8-8) 7.81 0.138 Hb after transfusion 8.9 (8.4-10) 101 0.382 No of blood transfusion unites given 1 (0-1) 1 (0-3) 0.491 Serum creatinine At discharge 111 (83.25-142.75) 151 (113.5-222.5) 0.096 6 mo 102.5 (80.5-123) 120 (80-156) 0.420 12 mo 99.5 (81.75-119.25) 124.5 (92.5-140.75) 0.201 18 mo 105 (84.25-119) 107 (72-) 0.894 Death 1 (1) 1 (20) 0.093 DGF 9 (9) 2 (40) 0.084 No. of infections 0 (0-1) 1 (0-2) 0.651 Types of infections None 53 (53) 2 (40) 0.188 UTI 30 (28.6) 29 (29) 1 Pnemonia 1 (1) 1 (1) 1 TB 1 (1) 1 (1) 1 BK 7 (6.7) 7 (7) 1 Bactremia 4 (3.8) 4 (4) 1 Epidediymo-orchitis 2 (1.9) 2 (2) 1 Gastroenteritis 2 (1.9) 1 (1) 0.093 Herpes zoster 1 (1) 1 (1) 1 Infected AVF 1 (1) 1 (1) 1 Perianal abcess 1 (1) 1 (1) 1 COVID-19 9 (8.6) 8 (8) 0.367 URTI 2 (1.9) 1 (1) 0.093 CMV 11 (11) 1 (20) 0.462 Urological complications None 90 (90) 5 (100) 1 Allograft artery stenosis 1 (1) 0 (0) Collection 3 (3) 0 (0) Lymphocele 1 (1) 0 (0) Obstrctive uropathy 1 (1) 0 (0) Perinephric collection and ureteric stricture 2 (2) 0 (0) Unrogenic bladder 1 (1) 0 (0) Urinary leak 1 (1) 0 (0) Urological complications No 90 (90) 5 (100) 1 Yes 10 (10) 0 (0)
Table 6 Multiple linear regression analysis of the association between creatinine change and eligible study variables
B SE 95%CI P value(Intercept) 70.23 18.72 33.54 to 106.92 < 0.001 Male vs female -1.74 18.59 -38.17 to 34.69 0.925 No. of PRBCs 20.14 6.99 6.45 to 33.84 0.004 Creatinine at discharge -0.79 0.12 -1.03 to -0.54 < 0.001