Predictive factors for anemia six and twelve months after orthotopic liver transplantation.
BACKGROUND
The aim of our study was to determine the prevalence and predictive factors for post-transplant anemia (PTA) at 6 (M6) and 12 (M12) months after orthotopic liver-transplant (OLT) in a cohort of 97 consecutive patients.


METHODS
Anemia was defined at M6 and M12 according to the World Health Organization criteria, i.e., a hemoglobin level of <12 g/dL for women and <13 g/dL for men. Immunosuppression relied on tacrolimus and steroids with or without mycophenolate mofetil.


RESULTS
Anemia was present in 64.5%, 50%, and 52.8% of patients before OLT and at M6 and M12, respectively. Of the anemic patients, 33% (M6) and 30.3% (M12) received recombinant erythropoietin therapy. In multivariate analysis, the independent predictive factors for anemia at M6 were mean corpuscular volume (<85 fl) at day 7, daily steroid dosage (<0.3 mg/kg), serum creatinine (>130 micromol/L), and hemoglobin level (<11 g/dL) 1 month after OLT (M1). Independent predictive factors for anemia at M12 were daily steroid dosage at M1 (<0.3 mg/kg), hematocrit at M1 (<33%), red blood cell count at M6 (<3.75 T/L), daily dosage at M1 of cyclosporine and tacrolimus, and OLT for causes other than alcohol abuse.


CONCLUSIONS
Anemia is highly prevalent within the first year post-OLT. This deserves further investigation and appropriate treatment.
Guitard
Joelle
J
Multiorgan Transplant Unit, University Hospital, CHU Rangueil, France.
Ribes
David
D
Kamar
Nassim
N
Muscari
Fabrice
F
Lavayssière
Laurence
L
Suc
Bertrand
B
Esposito
Laure
L
Perron
Jean-Marie
JM
Rostaing
Lionel
L
D000328:Adult; D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use; D004906:Erythrocyte Count; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000517:prevention & control; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016559:Tacrolimus / Q000627:therapeutic use; D013997:Time Factors
D006454:Hemoglobins; D007166:Immunosuppressive Agents; D004921:Erythropoietin; D016572:Cyclosporine; D003404:Creatinine; D016559:Tacrolimus