The impact of post-transplant hemoglobin level on renal allograft outcome.

Abstract

BACKGROUND:

Anemia is a common complication of chronic renal disease and renal transplantation. Early post-transplant anemia is the consequence of blood loss, immunosuppressant therapy, and failure to produce sufficient erythropoietin. Late post-transplant anemia has been attributed to drug therapy, renal dysfunction, and infection. The effect of post-transplant anemia on renal allograft survival and acute rejection rates is not established. The aim of this study was to examine the impact of post-transplant anemia on renal function and allograft outcomes.

MATERIALS AND METHODS:

We included 411 patients who underwent living or deceased donor renal transplantations in our center from April 1990 to March 2010. The patients were divided into 2 groups according to their postoperative hemoglobin level at 1 month: anemic group (<12.0 g/dL in men, <11.0 g/dL in women) and nonanemic group (≥ 12.0 g/dL in men, ≥ 11.0 g/dL in women). The outcome measures included postoperative serum creatinine levels at 12 and 36 months, acute and chronic rejection rates, as well as long-term graft survival.

RESULTS:

The acute and chronic rejection rates were significantly higher in the anemic group: 28.1% versus 19.7% (P = .000) and 24.1% versus 19.7% (P = .027), respectively. Postoperative serum creatinine levels at 12 and 36 months were not significantly different in patients with functioning grafts regardless of their anemia status (P = .530 and P = .430, respectively). Graft survival was lower with anemia: 85.4% versus 93.8% at 5 years, and 74.8% versus 83.5% at 10 years (P = .040).

CONCLUSIONS:

Post-transplant anemia was associated with poorer renal function at 12 months, higher acute rejection rates, and worse long-term renal allograft outcomes compared with subjects displaying normal hemoglobin levels.

• Authors: J Y Choi, O J Kwon
• Journal: Transplantation proceedings (Transplant Proc) Vol. 45 Issue 4 Pg. 1553-7 (May 2013) ISSN: 1873-2623 [Electronic] United States
• PMID: 23726618 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Hemoglobins

Topics

• Adult
• Anemia (diagnosis)
• Female
• Hemoglobins (analysis)
• Humans
• Kidney Transplantation
• Male
• Middle Aged
• Treatment Outcome