Post-transplant anemia in pediatric patients and its impact on patient and graft survival: single center experience

Osama Gheith; Ehab Wafa; Ayman Refaie; Nabil Hassan; Amani Mostafa; Hussein Sheashaa; Ahmaed Shokeir; Mohamed Kamal; Mohamed A Ghoneim

doi:10.21804/13-1-777

Osama Gheith Department of Nephrology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Ehab Wafa Department of Nephrology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Ayman Refaie Department of Nephrology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Nabil Hassan Department of Nephrology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Amani Mostafa Department of Immunology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Hussein Sheashaa Department of Nephrology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Ahmaed Shokeir Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Mohamed Kamal Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Mohamed A Ghoneim Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

Abstract

Introduction: Post-transplantation anemia (PTA)occurs frequently, with prevalence rates between 20and 60% depending on the criteria used for defininganemia.

Aim of the work: We aimed to assess the prevalenceof anemia after 6 months of transplantation inpediatric renal transplant patients under differentprotocols of immunosuppression, and to determinethe impact of anemia upon long-term patient andgraft survival.

Patients and methods: Based on the data of 108renal transplants performed in our center, patientswere categorized after 6 months according to theirhemoglobin (Hb) levels into two groups. The firstgroup with Hb more than 11gm/dl (group I, 29cases) and the second group with Hb lessthan11gm/dl (group II, 79cases). We compared thetwo groups regarding post transplant complications(rejection episodes, hypertension, diabetes mellitus,infections, hepatic dysfunction, and patient andgraft survival.

Results: we found no significant difference betweenthe two groups regarding rejection episodes.However, the percentage of cases with chronicallograft nephropathy was significantly higher in the anemic group. The survivors with functioning graftswere significantly higher in cases with normal Hb.Moreover, living cases with graft failure weresignificantly higher in anemic group. Graft survivalrate was better in the non anemic group. However,no difference in patient survival was detected. Also,we found no difference between the two groupsregarding post-transplant complications.

Conclusions: From this study, we can conclude thatthe prevalence of post-transplant anemia is highpediatric renal transplant patients especially thosereceiving CNI and MMF, and it was associated withpoorer graft outcome but no effect on patientsurvival.