Blood Transfusion and Venous Thromboembolism in Kidney Transplant Patients
Bibliographic record
Abstract
Background: Receipt of a red blood cell transfusion (RBCT) is common in kidney transplant patients and could have pro-thrombotic effects predisposing to venous thromboembolism (VTE). The aim of this study is to examine the risks for the development of VTE associated with the receipt of RBCT in kidney transplant patients. Methods: We conducted a retrospective cohort study of all adult kidney transplant recipients at The Ottawa Hospital from 2002 to 2018, using administrative databases and medical chart review. The exposure of interest was receipt of a RBCT after transplant. Cox proportional hazards models were used to calculate hazard ratios (HR) for venous thromboembolism [VTE] (deep venous thrombosis [DVT] or pulmonary embolism [PE]) using RBCT as a time-varying, cumulative exposure. Results: Out of 1,258 kidney transplants recipients, 468 (37%) received a total of 2,373 RBCT after transplant (incidence of 33 RBCT per 100 patient-years). During follow up, 79 study participants (6.3%) developed VTE, 72 had a DVT (5.7%) and 22 had a PE (1.8%). For the receipt of 1, 2, 3-5 and >5 RBCT, compared to individuals never transfused, the number of events and adjusted HR (95% CI) for VTE was 6 events (6.2%) HR 1.57 (0.69 to 3.58), 9 events (7.6%) HR 2.54 (1.30 to 4.96), 15 events (11.9%) HR 2.73 (1.38 to 5.41) and 23 events (18.1%) HR 5.77 (2.99 to 11.14) respectively; for DVT it was 6 events (6.2%) HR 1.94 (0.84 to 4.48), 9 events (7.6%) HR 2.92 (1.44 to 5.94), 14 events (11.1%) HR 3.29 (1.63 to 6.65) and 21 events (16.5%) HR 6.97 (3.53 to 13.76), respectively. For PE, among transfused individuals there were 14 events (3.0%) and the HR was 2.40 (1.02 to 5.61). Conclusions: The risk for developing VTE, DVT and PE was significantly associated with the receipt of a RBCT in kidney transplant patients. Receipt of a RBCT should prompt considerations for judicious monitoring and assessment for possible thrombosis. Cox model HRs for VTE events based on RBCT exposure* Adjusted for age, sex, transplant type, PRA, presence of diabetes, presence of cardiovascular disease, and type of maintenance therapy. PE analysis was adjusted only for age given low number of events (22)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".