2010 - TTS International Congress


This page contains exclusive content for the member of the following sections: TTS. Log in to view.

Complications Cardiovascular

31.18 - Anaemia after renal transplantation. Incidence and impact on graft outcome. Departments of Nephrology and *Urology. Hospital Ramón y Cajal. Madrid

Presenter: Sara, Jimenez, Madrid, Spain
Authors: Marcén R., Jimenez S., Fernández A., Galeano C., Villacorta J., Teruel J., Burgos F., Quereda C.

ANAEMIA AFTER RENAL TRANSPLANTATION. INCIDENCE AND IMPACT ON GRAFT OUTCOME. DEPARTMENTS OF NEPHROLOGY AND *UROLOGY. HOSPITAL RAMóN Y CAJAL. MADRID

COMPLICATIONS - CARDIOVASCULAR

R. Marcén1, S. Jimenez2, A. Fernández3, C. Galeano2, J. Villacorta2, J.L. Teruel2, F.J. Burgos2, C. Quereda2
1, Hospital Universitario Ramón y Cajal, Madrid/SPAIN, 2Nephrology, Hospital Ramon y Cajal, Madrid/SPAIN, 3, Hospital Ramon y Cajal, Madrid/SPAIN

Body: Background: Post-transplant anaemia (PTA) is a common complication after transplantation but few longitudinal studies have been performed. Moreover, its impact on morbidity and mortality in renal transplant recipients is controversial. The purpose of the present study was to investigate the evolution of PTA during the first three years after transplantation, its treatment, the possible risk factors and its effects on morbidity and mortality. Patients and methods: 207 recipients with a functionig graft at 12 months were included in the study. The immunosuppressive therapy was tacrolimus-based in 74% of patients, cyclosporine-based in 26% and 79% also received mycophenolate mofetil. Donor and recipient-related data at the time of transplant as well as graft function and anaemia parameters were prospectively collected at 1, 3, 6,12,24 and 36 months. Anaemia was defined following the World Health Organization (WHO) criteria: haemoglobin (Hb) concentration <13 g/dl in men and <12 g/dl in women. Results: The Hb concentration increased from 10.9 g/dl at 1 month to 13.5 g/dl at 12 months and remained almost unchanged at 36 months (13.7 g/dl). The prevalence of PTA was 88.5% at 1 month, 29.7% at 12 months and 24.2% at 36 months. There were no differences in age, gender, dialysis treatment, primary renal disease, induction therapy, incidence of acute rejection and of delayed graft function and immunosuppressive therapy between 12 months anaemic and non-anaemic recipients. Concentrations of ferritin, vitamin B12 and folic acid were similar in both groups at 12 months. In the univariate analysis, 12 month anaemia was associated with donor age, serum creatinine, haemoglobin, serum ferritin and bicarbonate at 3 months. Multivariate analysis showed that PTA at 12 months was only associated with 3 month serum haemoglobin (OR 0.51; 95%CI 0.13-0.68; p=0.000) and creatinine (OR 2.37; 95CI 1.15-4.84; p=0.018) levels. At 36 months, PTA was associated with female sex (OR 2.38; 95%CI 1.00-5.66: P=0.049), higher serum creatinine (OR 2.93; 95%CI 1.31-6.51; p=0.008) and negatively with serum albumin (OR 0.13; 95%CI 0.03-0.61; p=0.010). At 12 months, only 18% of recipients with PTA were on treatment with eritropoyesis stimulating agents and the percentage increased to 41% of recipients with Hb <11 g/dl. Six out of 11 patients with heart diseases in the first 6 months were anaemic. Poorer graft survival at 5 years was associated with 12 month anaemia (p=0.014) Conclusions: PTA anemia was common after transplantation and its incidence remained almost stable between 12 and 36 months. Variables associated with anemia were graft function at 12 months, and graft function and malnutrition/inflammation at 36 months. Anaemia could influence the appearance of heart diseases and was associated with poorer graft outcome.

Disclosure: All authors have declared no conflicts of interest.


Important Disclaimer

By viewing the material on this site you understand and accept that:

  1. The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
  2. The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
  3. The material is solely for educational purposes for qualified health care professionals.
  4. The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
  5. The information cannot be used as a substitute for professional care.
  6. The information does not represent a standard of care.
  7. No physician-patient relationship is being established.

Social

Contact

Staff Directory
+1-514-874-1717
info@tts.org

Address

The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada