A 34-year old patient with chronic glomerulonephritis has been receiving hemodialysis for the last three years. He has been waiting for a renal transplantation from cadaver. His blood type is A+ and he has been receiving transfusion for past six months. Which of the following factors contraindicate renal transplantation in this patient?

**Core Concept**
The question requires knowledge of the contraindications for renal transplantation, specifically in a patient with a history of blood transfusions and chronic glomerulonephritis. The underlying principle is the risk of sensitization to HLA (Human Leukocyte Antigens) and the presence of anti-HLA antibodies, which can lead to acute rejection of the transplanted kidney.

**Why the Correct Answer is Right**
In this patient, the long history of blood transfusions (six months) increases the risk of sensitization to HLA antigens. This is because each blood transfusion exposes the immune system to foreign HLA antigens, leading to the production of anti-HLA antibodies. These antibodies can then attack the transplanted kidney, leading to acute rejection. This is particularly concerning in a patient waiting for a cadaveric transplant, where the donor kidney's HLA antigens may not match the recipient's, increasing the risk of rejection.

**Why Each Wrong Option is Incorrect**

**Option A:** This option is not provided.

**Option B:** While a history of chronic glomerulonephritis is a significant comorbidity, it is not a direct contraindication for renal transplantation. In fact, transplantation is often considered for patients with end-stage renal disease due to chronic glomerulonephritis.

**Option C:** This option is not provided.

**Option D:** This option is not provided.

**Clinical Pearl / High-Yield Fact**
In patients with a history of blood transfusions, it's essential to perform cross-matching and HLA antibody screening before transplantation to minimize the risk of acute rejection. This may involve desensitization protocols to remove or reduce anti-HLA antibodies before transplantation.

**Correct Answer:** B.

✓ Correct Answer: C. Donor blood group B+