Autologous Blood Transfusion During Elective Surgery in a Candidate for Living Donor Transplantation: A Case Report

Magdalena Jankowska; Lin Akily; William Karlsen; Anna Jaźwińska; Hanna Suchanek; Alicja Dębska-Ślizień

doi:10.1016/j.transproceed.2024.01.059

Autologous Blood Transfusion During Elective Surgery in a Candidate for Living Donor Transplantation: A Case Report

Transplant Proc. 2024 Feb 19:S0041-1345(24)00082-4. doi: 10.1016/j.transproceed.2024.01.059. Online ahead of print.

Authors

Magdalena Jankowska¹, Lin Akily², William Karlsen², Anna Jaźwińska³, Hanna Suchanek⁴, Alicja Dębska-Ślizień⁵

Affiliations

¹ Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Poland. Electronic address: maja@gumed.edu.pl.
² Faculty of Medicine, English Division, Medical University of Gdansk, Poland.
³ Regional Center for Blood Donation and Blood Treatment, Gdansk, Poland.
⁴ Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdansk, Poland.
⁵ Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Poland.

PMID: 38378339
DOI: 10.1016/j.transproceed.2024.01.059

Abstract

Background: Blood transfusions are risk factors for alloimmunization and unfavorable outcomes in solid organ transplant recipients.

Purpose: We propose the adoption of autologous blood transfusion (ABT) in transplant candidates and recipients referred to elective surgery.

Methods: We present a case of a 45-year-old man with chronic kidney disease stage 5 due to polycystic kidney disease, who was qualified for a native kidney nephrectomy (NKN) before kidney transplantation. Before the scheduled surgery, the patient was referred to a blood donation center for blood collection.

Results: During 2 consecutive visits, autologous blood was collected uneventfully, and this allowed for the preparation of 2 units of red blood cell concentrates and a unit of plasma. Pre- and post-donation hemoglobin values were 11.9 and 10.4 g/dL, respectively. The NKN procedure was complicated by intra-abdominal bleeding from an accessory aberrant artery of the kidney. Hemoglobin dropped to 6.8 g/dL and was treated with ABT, followed by artery embolization. This allowed for an increase of hemoglobin to 8.3 mg/dL and avoidance of allotransfusion. Six weeks after NKN, the patient underwent successful kidney transplantation from a living donor. Panel reactive antibodies before transplantation were 0%, and graft function has been excellent during 20 months of observation.

Conclusion: An autologous blood collection is a feasible option for patients with chronic kidney disease. ABT should be considered the procedure of choice when qualifying potential waiting list candidates and solid organ recipients for elective surgeries.