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

Abstract

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

Aim of the work: We aimed to assess the prevalence of anemia after 6 months of transplantation inpediatric renal transplant patients under different protocols of immunosuppression, and to determine the impact of anemia upon long-term patient and graft survival.

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

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

Conclusions: From this study, we can conclude that the prevalence of post-transplant anemia is high pediatric renal transplant patients especially those receiving CNI and MMF, and it was associated with poorer graft outcome but no effect on patient survival.