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Peer-reviewedCC BYHematology, transfusion and cell therapy

Prevalence and predictors of early blood transfusion in renal transplant recipients: a retrospective study.

  • Pukar Chandra Shrestha1
  • Kalpana Kumari Shrestha2
  • Arati Rai3
  • Dipesh Shrestha1
  • Sumit Acharya2
  • Rupesh Kumar Jha1
  • Hari Prasad Baral1
  • Rojan Adhikari1
  • Bikash Khadka1
  • Bikkin Dangol1
  • Milan Shrestha1
  • Lochan Shrestha1
5 more authors
  • Sanisha Karki4
  • Chahana Bogati4
  • Puja Khadka4
  • Binita Kutu4
  • Sat Prasad Nepal5
5 affiliations
  1. 1Department of Transplant Surgery and Urology, Shahid Dharmabhakta National Transplant Center (SDNTC), Bhaktapur, Nepal.
  2. 2Department of Nephrology, Shahid Dharmabhakta National Transplant Center (SDNTC), Bhaktapur, Nepal.
  3. 3Department of Anesthesia, Shahid Dharmabhakta National Transplant Center (SDNTC), Bhaktapur, Nepal.
  4. 4Department of Nursing, Shahid Dharmabhakta National Transplant Center (SDNTC), Bhaktapur, Nepal.
  5. 5Department of Transplant Surgery and Urology, Shahid Dharmabhakta National Transplant Center (SDNTC), Bhaktapur, Nepal. Electronic address: [email protected].
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Abstract

Background

Anemia associated with chronic kidney disease is driven by reduced erythropoietin synthesis, chronic inflammation, and decreased red blood cell lifespan. During and after renal transplant surgery, recipients may need blood transfusions. Transfusion rates exhibit significant inter-center variability, largely driven by differing clinical criteria among transplant surgery, nephrology, and intensive care units.Study design and methods

A retrospective study was conducted of 407 renal transplant recipients who underwent transplantation from May 15, 2023 to August 16, 2025 at the Shahid Dharmabhakta National Transplant Center, Nepal. Early transfusion was defined as any blood product administration occurring within 14 days post-surgery. Clinical and Laboratory variables were compared between transfused and non-transfused patients using either the Mann-Whitney U test or chi-square test as appropriate. Variables significant in univariate analysis were included in multivariate logistic regression to identify predictors of transfusion.Results

Ninety-five patients (23.34%) required transfusions with leukoreduced red blood cells being the most common blood product. Univariate analysis revealed that preoperative hemoglobin levels, diabetic nephropathy, and the length of hospital stay were significantly associated with transfusion requirements. Multivariate analysis showed that preoperative hemoglobin and length of stay were predictors of transfusion. The hemoglobin nadir for the transfused group reached a mean of 6.3 ± 1.05 g/dL and a median of 6.1 g/dL, with an interquartile range from 4.2 to 10.0 g/dL.Discussion

The results of this study show that a conservative transfusion approach can be effective in achieving good clinical outcomes, especially in resource limited centers.

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Cite

BibTeXRIS
BibTeX
@article{shrestha2026prevalence,
  title = {{Prevalence and predictors of early blood transfusion in renal transplant recipients: a retrospective study.}},
  author = {Pukar Chandra Shrestha and Kalpana Kumari Shrestha and Arati Rai and Dipesh Shrestha and Sumit Acharya and Rupesh Kumar Jha and Hari Prasad Baral and Rojan Adhikari and Bikash Khadka and Bikkin Dangol and Milan Shrestha and Lochan Shrestha and Sanisha Karki and Chahana Bogati and Puja Khadka and Binita Kutu and Sat Prasad Nepal},
  journal = {Hematology, transfusion and cell therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.htct.2026.108547},
  url = {https://europepmc.org/article/MED/42887298},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Prevalence and predictors of early blood transfusion in renal transplant recipients: a retrospective study.
AU  - Pukar Chandra Shrestha
AU  - Kalpana Kumari Shrestha
AU  - Arati Rai
AU  - Dipesh Shrestha
AU  - Sumit Acharya
AU  - Rupesh Kumar Jha
AU  - Hari Prasad Baral
AU  - Rojan Adhikari
AU  - Bikash Khadka
AU  - Bikkin Dangol
AU  - Milan Shrestha
AU  - Lochan Shrestha
AU  - Sanisha Karki
AU  - Chahana Bogati
AU  - Puja Khadka
AU  - Binita Kutu
AU  - Sat Prasad Nepal
PY  - 2026
DA  - 2026/10/16
JO  - Hematology, transfusion and cell therapy
DO  - 10.1016/j.htct.2026.108547
UR  - https://europepmc.org/article/MED/42887298
AB  - Background  Anemia associated with chronic kidney disease is driven by reduced erythropoietin synthesis, chronic inflammation, and decreased red blood cell lifespan. During and after renal transplant surgery, recipients may need blood transfusions. Transfusion rates exhibit significant inter-center variability, largely driven by differing clinical criteria among transplant surgery, nephrology, and intensive care units.Study design and methods  A retrospective study was conducted of 407 renal transplant recipients who underwent transplantation from May 15, 2023 to August 16, 2025 at the Shahid Dharmabhakta National Transplant Center, Nepal. Early transfusion was defined as any blood product administration occurring within 14 days post-surgery. Clinical and Laboratory variables were compared between transfused and non-transfused patients using either the Mann-Whitney U test or chi-square test as appropriate. Variables significant in univariate analysis were included in multivariate logistic regression to identify predictors of transfusion.Results  Ninety-five patients (23.34%) required transfusions with leukoreduced red blood cells being the most common blood product. Univariate analysis revealed that preoperative hemoglobin levels, diabetic nephropathy, and the length of hospital stay were significantly associated with transfusion requirements. Multivariate analysis showed that preoperative hemoglobin and length of stay were predictors of transfusion. The hemoglobin nadir for the transfused group reached a mean of 6.3 ± 1.05 g/dL and a median of 6.1 g/dL, with an interquartile range from 4.2 to 10.0 g/dL.Discussion  The results of this study show that a conservative transfusion approach can be effective in achieving good clinical outcomes, especially in resource limited centers.
SN  - 2531-1379
SN  - 2531-1387
ER  -