Late Post-transplant Anemia in Adult Renal Transplant Recipients. An Under-recognized Problem?
Article first published online: 23 MAY 2002
American Journal of Transplantation
Volume 2, Issue 5, pages 429–435, May 2002
How to Cite
Yorgin, P. D., Scandling, J. D., Belson, A., Sanchez, J., Alexander, S. R. and Andreoni, K. A. (2002), Late Post-transplant Anemia in Adult Renal Transplant Recipients. An Under-recognized Problem?. American Journal of Transplantation, 2: 429–435. doi: 10.1034/j.1600-6143.2002.20506.x
- Issue published online: 23 MAY 2002
- Article first published online: 23 MAY 2002
- Received 18 June 2001, revised and accepted for publication 3 December 2001
- Calculated creatinine clearance;
- iron deficiency;
- mycophenolate mofetil
Post-transplant anemia (PTA), a frequent complication during the first 3–6 months after transplant, is thought to be uncommon during the late post-transplant period. A study population of adults (> 18 years) transplanted during 1995 at Stanford University (n = 88) and University of North Carolina (n = 40) was selected. Data-collection points were 0, 1, 2, 3, 4 and 5 years post transplant. Anemia was defined as a hematocrit < 33 volume percentage. Thirty percent of patients were anemic at some time during the post-transplant period. The prevalence of PTA increased over time; by 5 years post transplant, 26% of the patients were anemic. Anemia occurred in 62.5% of patients converted from azathioprine to mycophenolate mofetil. A multivariate logistic regression model demonstrated a correlation between anemia and serum total CO2 (p = 0.002), BUN (p = 0.04), and creatinine (p = 0.045) at 1 year post transplant. At 5 years post transplant, only serum total CO2 (p = 0.0004) correlated with anemia. Thus, diminished renal excretory function and metabolic acidosis appear to be the most important correlates of late PTA. These findings should be interpreted in view of the fact that the newer immunosuppressive agents may have an even more profound effect on anemia and its recovery after transplantation.