Blood Transfusions in Patients Waiting for Kidney Transplantatio
What are the recommendations for giving blood transfusions to patients waiting for kidney transplantation? Is there a need to wash or irradiate blood or blood products before transfusion? Should packed cells be administered through a filter?

The immunogenicity of blood relates primarily to the platelets and white blood cells (WBCs). Platelets are usually separated from packed red cells, but WBCs may not be. Filtering blood should remove nearly all of the WBCs and render the blood less likely to sensitize a patient, but it is still possible. Ideally, in this era, erythropoietin and iron should render blood transfusions almost completely unnecessary. If blood needs to be given, filtering is mandatory at a minimum. Historically, some clinicians have administered immunosuppression (azathioprine or mycophenolate mofetil) during and after a transfusion to minimize the risk of sensitization, although I do not know if this has been subjected to a formal trial.