#2907 Characterization of patients needing red blood cell transfusion after kidney transplant

Abstract

Abstract Background and Aims After kidney transplant there is often need of red blood cell (RBC) transfusion because acute bleeding associated with surgery; or because multifactorial progressive anemization the days after. The aim of this work is to describe the characteristics of transfused kidney transplant recipients (KTR) and compare them to nontransfused controls. Method Retrospective observational study, reviewing the data from electronic medical records of patients receiving a kidney transplant in our hospital during 2022. Results During 2022, 160 kidney transplants were performed in adult people in our hospital and 66 (41.25%) KTR were transfused; some of them receiving the first red blood cell concentration (RBCC) during surgery (19.7%), the rest after surgery hospitalization because acute (10.6%) or progressive (69.7%) anemization. The total number of RBCC received was 1 in the 15% of transfused KTR, 2 in the 48%, 3 in the 8% and ≥ 4CH in the 29%. Among transfused KTR, the 13.6% kidney grafts came from living donors, 48.5% from Maastricht III, 36.4% from brain death and 1.5% from Maastricht II, whereas the kidney grafts of nontransfunded controls came from living donors (11.7%), Maastricht III (54.26%), encephalic death (32.98%) and Maastricht II (1.06%). The mean age of the transfused KTR was 62 years, 63.6% were males, 14.1% with ischemic heart disease, 6.3% with heart failure, moderate-severe valvular heart disease. The 12.12% were treated with acenocoumarol and the 25.7% with acetylsalicylic acid before the transplant hospitalization (whereas in nontransfunded controls the percentages were 10.6% and 21.3% respectively). Haemoglobin (Hb) levels previous to the surgery was lower in transfused KTR, presenting Hb <10 g/dl in the 10.6% of the recipients, whereas in nontransfunded controls was 2.1%. Moreover, ferritin levels were <100 ng/ml in 13.6% and transferrin saturation index was <20% in the 30.3% (whereas in nontransfunded controls it was 25.53% and 38.29% respectively). The mean of Hb before the transplant surgery in transfused KTR was 11.7 ± 1.4 g/dl, and before RBCC transfusion the median was 7.8 g/dl [7.6-8.1]. Conclusion Although more studies are needed, it is interesting to know the characteristics of the KTR that need RBC transfusion in order to asses measures (such us for example, Hb, iron … pretransplant adequate thresholds), in order to avoid if it is possible, unnecessary RBC transfusions.