144 Do Allografts Present a Risk to Burn Patients: Allografts and HLA-Sensitization

Abstract Objective This meta-analysis aimed to quantify sensitization rates following allograft usage and determine whether allografts have an increased risk of long-term sensitization compared to alternative therapies in burn patients. Methods Systematic review and meta-analysis of post-operative sensitization in burn patients were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance (Prospero registration: CRD42024497137). Database searches were conducted on MEDLINE and Embase using ProQuest Dialog. We included all studies reporting post-operative sensitization in burn patients that were not case series or singular case reports. Meta-analysis was used to compare the risk of sensitization for allograft versus alternative therapies. Results Six studies (Allograft Patients: 71 Non-Allograft Patients: 95) were included (n=166). Overall, 73% (CI: 39%-92%) of burn patients were sensitized following allograft. Patients receiving allograft were at a significantly increased risk of sensitization (OR 13.14 [95% CI: 1.32-131.00]). However, on sub-group analysis, when directly comparing patients who received allograft and transfusion versus those who received transfusion alone, there was not a significantly increased risk of sensitization (OR 7.68 [95% CI: .61-95.86]). Conclusion Allograft is associated with an increased risk of sensitization in burn patients. However, it is unclear whether burn patients already receiving transfusion will have an increased risk of sensitization from adding allograft. Further studies should explore the multifactorial causes of sensitization within the burned population to explain the risks of allograft and/or transfusion. Clinicians must carefully weigh the immediate benefits of allografts against the potential long-term challenges of sensitization, especially where alternative wound therapies are possible.