2025-02-252022-10-26https://repositorio.cmmg.edu.br/handle/123456789/67Introduction: Kidney transplant is considered the gold standard treatment for end stage kidney disease. However, despite the advances in this area, rejections are still the main causes of graft loss in the first year post-transplant. Blood transfusions in the postoperative period of a kidney transplant may induce antibody formation, responsible for the antibody-mediated rejection (ABMR) episodes, thus a better understanding of these events and whether there is a relationship with poorer graft survival is needed. Objectives: To analyze the relationship between blood transfusions in the first month post-transplantation and the occurrence of rejections as well as the impact on kidney function, global and graft survival in one year. Material and methods: A retrospective cohort study conducted with 445 patients who underwent living and deceased kidney transplants at University Hospital of the Faculty of Medical Sciences between 2008 and 2018. The participants were divided between those who received transfusion in the first month post-transplant (BTG) and those who did not receive hemotransfusions in the same period (NBTG). They had a one-year follow-up to assess the occurrence of rejections, function and graft survival. Results: Stratifying the 445 patients, the BTG group was composed of 125 and the NBTG of 320 patients. Regarding the main outcomes, BTG patients had a higher occurrence of ABMR in the first year (13.60%) compared to NBTG (4.38%) (p<0.001). Transfused patients developed de novo donor specific antibodies (DSA) in a higher proportion than non-transfused patients (p<0.001) in the first year post-transplantation. Transfused patients maintained higher creatinine levels in the first and third post-transplant month (p=0.012 and 0.038, respectively). The graft survival rate was worse, with more first year failures (11.2%) in the BTG group than in the NBTG group (2.5%) (p<0.001). The predictive risk factors for de novo DSA formation at one year after transplantation were the number of HLA mismatches (OR 1.95, p=0.031), not receive induction immunotherapy before KT (OR 1.81, p=0.043) and having received blood transfusion after KT (OR 1.53, p=0.039). Mortality was higher in the BTG group (7.20%) than in the NBTG group (2.81%) (p=0.035). Conclusion: Blood transfusions in the first month after transplantation are related to a higher occurrence of ABMR, as well as a worsening of renal function, reduced graft survival rate and higher mortality in the first year after transplantation.Acesso abertoDoença renal crônica, Transplante renal, Rejeição de enxerto, Anemia, Transfusão sanguínea; Chronic kidney disease, Kidney transplant, Allograft rejection, Anemia, Blood transfusion.Dissertação4.01.00.00-6 - Medicina