Predictive factors for anemia within the first year after orthotopic liver transplantation.
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.
Guitard
J
J
Multiorgan Transplant Unit, University Hospital, CHU Rangueil, 1 avenue Jean Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
Ribes
D
D
Kamar
N
N
Muscari
F
F
Lavayssière
L
L
Suc
B
B
Esposito
L
L
Perron
J-M
JM
Rostaing
L
L
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
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