It is widely accepted that blood transfusions can cause allosensitisation, but it is often reported that new HLA antibodies are non-specific and transient. This study explores the effect of blood transfusion on allosensitisation in waitlisted transplant patients including the development of transfusion specific antibodies (TSAs), whilst they remain on the waiting list and longitudinally following subsequent transplantation. A total of 105 blood donors of transfusions received by 50 patients on the transplant waiting list were HLA typed. De novo HLA antibodies developed in 62% of patients following transfusion, with 34% of patients having at least one TSA. TSAs developed in 23% of patients with no circulating HLA antibodies at the time of transfusion and in 50% of patients with circulating HLA antibodies. This was associated with an average increase in calculated reaction frequency of 16.4%. Of the 34 patients who were transplanted the majority received a kidney with at least 1 shared HLA specificity with a transfusion donor. After transplantation 14.7% had a newly detected TSA within 3 months. These patients had higher rates of rejection, specifically antibody mediated rejection, at 3 years. The use of HLA-selected blood for waitlisted patients, where transfusion is unavoidable, could therefore improve transplant outcomes.

中文翻译：

---

肾移植前输血后输血特异性同种免疫反应。


人们普遍认为输血可引起同种异体增敏，但经常报道新的 HLA 抗体是非特异性和短暂的。本研究探讨了输血对等待名单上的移植患者同种异体增敏的影响，包括输血特异性抗体 （TSA） 的产生，同时他们仍然在等待名单上并在随后的移植后纵向进行。移植等待名单上的 105 名患者接受的 50 名输血献血者为 HLA 分型。62% 的患者在输血后出现新发 HLA 抗体，其中 34% 的患者至少患有一种 TSA。输血时 23% 的无循环 HLA 抗体患者和 50% 有循环 HLA 抗体的患者出现 TSA。这与计算的反应频率平均增加 16.4% 有关。在接受移植的 34 名患者中，大多数接受了至少 1 个与输血供体共享 HLA 特异性的肾脏。移植后 14.7% 的患者在 3 个月内新检测到 TSA。这些患者在 3 年时具有更高的排斥反应率，特别是抗体介导的排斥反应。因此，对于不可避免地输血的等待名单患者，使用 HLA 选择的血液可以改善移植结果。