{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:58:28Z","timestamp":1791874708356,"version":"4.3.4"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Up to 30% of patients develop anti\u2010HLA antibodies following a single transfusion with leukoreduced packed red blood cells (pRBCs). While some speculate that irradiation of pRBCs could reduce the risk of allosensitization, its effect in clinical practice remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010center, retrospective study was conducted with 93 pediatric solid organ transplant (SOT) candidates from January 2013 to July 2022. All participants had a baseline calculated panel reactive antibody (cPRA) of 0% and underwent repeat cPRA testing at least 28\u2009days after pRBC transfusion to evaluate for de novo allosensitization. Patients were stratified by pRBC preparation: exclusively irradiated pRBC versus any exposure non\u2010irradiated pRBC. The primary outcome was the incidence of interval allosensitization in each group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 17 of 93 patients (18.3%) developed anti\u2010HLA antibodies. In the non\u2010irradiated group, allosensitization occurred in 8\/39 patients (20.5%) compared to 9\/54 (16.7%) in the irradiated group (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7866). In multivariable analysis, the number of pRBC transfusions was the only risk factor to increase the odds of allosensitization (OR 1.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Number of non\u2010pRBC sensitizing events was paradoxically found to be protective (OR 0.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Chronic immunosuppression did not mitigate allosensitization risk, although IVIG was associated with a non\u2010significant risk reduction (OR 0.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The number of pRBC transfusions remains the strongest modifiable risk factor for pre\u2010transplant allosensitization in pediatric SOT candidates. Irradiation of pRBC did not significantly reduce the risk of transfusion\u2010associated allosensitization in this population. IVIG may have a protective effect and should be further evaluated in a future, better powered study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70265","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T04:39:04Z","timestamp":1767933544000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Allosensitization From Blood Transfusion in Pediatric Solid Organ Transplant Candidates: Impact of Irradiation"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8883-7776","authenticated-orcid":false,"given":"Corinne M.","family":"Hite","sequence":"first","affiliation":[{"name":"Division of Nephrology &amp; Hypertension, Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8238-7939","authenticated-orcid":false,"given":"Kyle A.","family":"Merrill","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis &amp; Transplantation, Stead Family Department of Pediatrics University of Iowa Health Care  Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford","family":"Chin","sequence":"additional","affiliation":[{"name":"Heart Institute, Department of Pediatric Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6734-6052","authenticated-orcid":false,"suffix":"Jr","given":"Don","family":"Hayes","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Pulmonary Medicine, Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander G.","family":"Miethke","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Gastroenterology, Hepatology &amp; Nutrition, Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel A.","family":"Kocoshis","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Gastroenterology, Hepatology &amp; Nutrition, Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0409-3799","authenticated-orcid":false,"given":"Charles D.","family":"Varnell","sequence":"additional","affiliation":[{"name":"Division of Nephrology &amp; Hypertension, Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"James M. Anderson Center for Health Systems Excellence Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5014-3435","authenticated-orcid":false,"given":"Stephanie","family":"Kinney","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Pathology and Laboratory Medicine Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Ambrosino","sequence":"additional","affiliation":[{"name":"Division of Pathology and Laboratory Medicine Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Brailey","sequence":"additional","affiliation":[{"name":"Hoxworth Blood Center University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K.","family":"Hooper","sequence":"additional","affiliation":[{"name":"Division of Nephrology &amp; Hypertension, Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"James M. 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