Posttransplant erythrocytosis in renal transplant recipients at Jeddah Kidney Center, Kingdom of Saudi Arabia.

Abstract

OBJECTIVES:

Posttransplant erythrocytosis is a well-known complication of renal transplant. It is a persistently elevated hematocrit level equal to or greater than 51%, or a hemoglobin level equal to or greater than 16 g/L, or both, in the absence of other causes.

MATERIALS AND METHODS:

We retrospectively reviewed this complication in patients who had received a renal transplant at our center between January 1991 and December 2005.

RESULTS:

Of 1655 renal transplant recipients, 159 patients (9.6%; 154 men, 5 women; mean age, 42 +/- 9 years) developed posttransplant erythrocytosis. The mean follow-up was 96 +/- 4 months. Posttransplant erythrocytosis appeared at an average of 8.2 +/- 5 months after transplant (range, 3-40 months) and lasted an average of 10.3 +/- 3 months (range, 7-35 months). In all 159 patients, the immunosuppressive medication regimen included prednisolone; in 144, cyclosporine was used, and in 108 patients, azathioprine was used, while in another group of patients, the latter 2 were changed to mycophenolate mofetil (n=38) and tacrolimus (n=13). Twenty-four patients (15%) were treated with phlebotomies, while 29 patients (18.2%) were given angiotensin-converting enzyme inhibitors. One hundred six patients were left untreated including 92 patients (57.9%) who received prophylactic anti-platelet medications. Remission of posttransplant erythrocytosis was seen in all treated and untreated patients. No thromboembolic complications occurred. Only 9 patients (5.7%) developed chronic allograft nephropathy during follow-up.

CONCLUSIONS:

Our findings suggest that posttransplant erythrocytosis is a benign condition affecting males more than females, usually manifesting in the first year after transplant. Remission of posttransplant erythrocytosis can be seen in all patients; however, some patients may require treatment with phlebotomy or angiotensin-converting enzyme inhibitors. Posttransplant erythrocytosis has no adverse effects on renal graft function.

• Authors: Nawal Basri, M Z Gendo, R Haider, K A K Abdullah, A Hassan, F A M Shaheen
• Journal: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation (Exp Clin Transplant) Vol. 5 Issue 1 Pg. 607-9 (Jun 2007) ISSN: 1304-0855 [Print] Turkey
• PMID: 17617052 (Publication Type: Journal Article)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Immunosuppressive Agents

Topics

• Adult
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Chronic Disease
• Female
• Follow-Up Studies
• Humans
• Immunosuppressive Agents (therapeutic use)
• Incidence
• Kidney Diseases (epidemiology, etiology)
• Kidney Transplantation (adverse effects)
• Male
• Middle Aged
• Phlebotomy
• Polycythemia (epidemiology, etiology, therapy)
• Remission, Spontaneous
• Retrospective Studies
• Saudi Arabia (epidemiology)
• Sex Distribution