Kidney transplant recipients who receive a red blood cell (RBC) transfusion are at elevated risk for venous thromboembolism (VTE), data presented during the American Society of Nephrology’s Kidney Week 2021 suggest.
“Our study presents novel findings highlighting another reason to limit the use of blood transfusions in kidney transplant recipients,” David Massicotte-Azarniouch, MD, of the University of Ottawa in Ontario, Canada, and colleagues concluded in a poster presentation.
The study, which was retrospective, included 1258 recipients of kidney transplants at The Ottawa Hospital from 2002 to 2018. Of these, 468 (37%) received a total of 2373 RBC transfusions after transplantation. During follow-up, VTE developed in 79 patients (6.3%), deep venous thrombosis (DVT) developed in 72 (5.7%), and pulmonary embolism (PE) occurred in 22 (1.8%).
Compared with no RBC transfusion, receipt of any RBC transfusion was significantly associated with approximately a 2.8-fold increased risk for VTE, 3.3-fold increased risk for DVT, and 2.4-fold increased risk for PE, after adjusting for age, sex, transplant type, presence of diabetes and cardiovascular disease, and type of maintenance therapy, Dr Massicotte-Azarniouch and colleagues reported.
The risks varied by number of RBC units received. Compared with no transfusion, receipt of 2, 3-5, and more than 5 RBC units was significantly associated with approximately 2.5-, 2.7-, and 5.8-fold increased risks for VTE events, respectively, and 2.9-, 3.3-, and 7.0-fold increased risks for DVT, respectively. Receipt of more than 5 RBC units was significantly associated with a 7.7-fold increased risk for PE.
“Receipt of blood transfusion in kidney transplant recipients is associated with a step-wise increased risk for VTE, DVT and PE as the number of transfusions increases,” the investigators stated.
Massicotte-Azarniouch, Sood MM, Fergusson DA, Chasse M, Tinmouth A, Knoll G. Blood transfusion and venous thromboembolism in kidney transplant patients. Presented at: Kidney Week 2021, November 2-7, 2021. Poster PO2119.