title: Predictive factors for anemia within the first year after orthotopic liver transplantation.
abstract: We sought to determine the prevalence and predictive factors for posttransplant anemia within the first year after orthotopic liver transplant (OLT) among 97 consecutive patients. Anemia was defined at months 6 and 12 according to the WHO criteria, that is, a hemoglobin (Hb) level of <12 g/dL for women and <13 g/dL for men. Immunosuppression relied on tacrolimus and steroids, with or without mycophenolate mofetil. Anemia was present in 64.5%, 50%, and 52.8% of patients pre-OLT versus 6 and 12. Thirty-three percent (month 6) and 30.3% (month 12) of anemic patients received recombinant erythropoietin therapy. A multivariate analysis revealed that the independent predictive factors for anemia at month 6 were mean corpuscular volume (<85 fL) at day 7, daily steroid dosage (<0.3 mg/kg), serum creatinine (>130 mumol/L), and Hb level (<11 g/dL) at month 1. Independent predictive factors for anemia at month 12 were daily steroid dosage at month 1 (<0.3 mg/kg), hematocrit at month 1 (<33%), red blood cell count at month 6 (<3.75 T/L), daily dosage at month 1 of cyclosporine or tacrolimus, and etiology of end-stage liver disease other than alcohol abuse. We concluded that anemia was highly prevalent within the first year of post-OLT. This observation deserves further investigation and appropriate treatment.
authors.affiliation: Multiorgan Transplant Unit, University Hospital, CHU Rangueil, 1 avenue Jean Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: J
authors.initials: J
authors.lastname: Guitard
authors.forename: D
authors.initials: D
authors.lastname: Ribes
authors.forename: N
authors.initials: N
authors.lastname: Kamar
authors.forename: F
authors.initials: F
authors.lastname: Muscari
authors.forename: L
authors.initials: L
authors.lastname: Lavayssière
authors.forename: B
authors.initials: B
authors.lastname: Suc
authors.forename: L
authors.initials: L
authors.lastname: Esposito
authors.forename: J-M
authors.initials: JM
authors.lastname: Perron
authors.forename: L
authors.initials: L
authors.lastname: Rostaing
mesh_terms: D000740:Anemia / Q000188:drug therapy* / Q000453:epidemiology*; D000998:Antiviral Agents / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D004911:Erythrocyte Volume; D004921:Erythropoietin / Q000627:therapeutic use; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011994:Recombinant Proteins; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014944:World Health Organization
chemical_list: D000998:Antiviral Agents; D006454:Hemoglobins; D007166:Immunosuppressive Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D004921:Erythropoietin; D011092:Polyethylene Glycols; D003404:Creatinine; C100416:peginterferon alfa-2a