Alloimmunization Against RBC Antigens Is Not Associated With Decreased Survival in Liver Transplant Recipients

Yevgen Chornenkyy, Alcino Pires Gama, Christopher Felicelli, Nigar Khurram, Adam L. Booth, Joseph R. Leventhal, Glenn Eugene Ramsey, Guang Yu Yang

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Improvement of liver transplantation (LT) outcomes requires better understanding of factors affecting survival. The presence of RBC alloantibodies (RBCAs) on survival in LT recipients was evaluated. Methods: This study was a single-center, retrospective cohort study reviewing transfusion records and all-cause mortality between 2002 and 2021. Results: Between 2002 and 2021, 2079 LTs were completed, 1,396 of which met inclusion criteria (1,305 RBCA negative; 91 RBCA positive [6.5%]). The cohorts were similar in age (mean [range], 55.8 [17-79] years vs 56.8 [25-73] years; P =. 41, respectively) or sex (RBCA negative, 859 [65%] men and 446 [35%] women vs RBCA positive, 51 [56%] men and 40 [44%] women; P =. 0684). Of 132 RBCAs detected, 10 were most common were to E (27.27%), Jka (15.91%), K (9.09%), C (8.33%), M (6.06%), D (5.3%), Fya (4.55%), e (2.27%), c (2.27%), and Jkb (2.27%). Twenty-seven patients (29.7%) had more than 1 RBCA; the most common combinations were C with Jka (7.4%) and E with Dia (7.4%). All-cause mortality was increased in men (men, 14.45 years vs women, 17.27 years; P =. 0266) and patients 65 years of age and older (≥65 years of age, 10.21 years vs <64 years of age, 17.22 years; P <. 0001). The presence of RBCA (≥1) did not affect all-cause mortality (RBCA negative, 14.17 years vs RBCA positive, 15.29 years; P =. 4367). The top 5 causes of death were infection (11.9%), primary malignancy (solid) (10.8%), recurrent malignancy (10.5%), cardiovascular arrest (7.1%), and pulmonary insufficiency/respiratory failure (5.7%). Conclusions: Survival in RBCA-positive LT recipients is no different from that in RBCA-negative LT recipients.

Original languageEnglish
Pages (from-to)255-262
Number of pages8
JournalAmerican journal of clinical pathology
Issue number3
StatePublished - Mar 1 2023


  • RBC transfusion
  • Transfusion practices (surgical)
  • Transplantation - solid organ


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