title: Posttransplant erythrocytosis in renal transplant recipients at Jeddah Kidney Center, Kingdom of Saudi Arabia.
abstract: OBJECTIVE
  Posttransplant erythrocytosis is a well-known complication of renal transplant. It is a persistently elevated hematocrit level equal to or greater than 51%, or a hemoglobin level equal to or greater than 16 g/L, or both, in the absence of other causes.
  
  
  METHODS
  We retrospectively reviewed this complication in patients who had received a renal transplant at our center between January 1991 and December 2005.
  
  
  RESULTS
  Of 1655 renal transplant recipients, 159 patients (9.6%; 154 men, 5 women; mean age, 42 +/- 9 years) developed posttransplant erythrocytosis. The mean follow-up was 96 +/- 4 months. Posttransplant erythrocytosis appeared at an average of 8.2 +/- 5 months after transplant (range, 3-40 months) and lasted an average of 10.3 +/- 3 months (range, 7-35 months). In all 159 patients, the immunosuppressive medication regimen included prednisolone; in 144, cyclosporine was used, and in 108 patients, azathioprine was used, while in another group of patients, the latter 2 were changed to mycophenolate mofetil (n=38) and tacrolimus (n=13). Twenty-four patients (15%) were treated with phlebotomies, while 29 patients (18.2%) were given angiotensin-converting enzyme inhibitors. One hundred six patients were left untreated including 92 patients (57.9%) who received prophylactic anti-platelet medications. Remission of posttransplant erythrocytosis was seen in all treated and untreated patients. No thromboembolic complications occurred. Only 9 patients (5.7%) developed chronic allograft nephropathy during follow-up.
  
  
  CONCLUSIONS
  Our findings suggest that posttransplant erythrocytosis is a benign condition affecting males more than females, usually manifesting in the first year after transplant. Remission of posttransplant erythrocytosis can be seen in all patients; however, some patients may require treatment with phlebotomy or angiotensin-converting enzyme inhibitors. Posttransplant erythrocytosis has no adverse effects on renal graft function.
authors.affiliation: King Fahd General Hospital, Jeddah Kidney Center, Jeddah, Kingdom of Saudi Arabia. nawalahbasri@yahoo.com
authors.forename: Nawal
authors.initials: N
authors.lastname: Basri
authors.forename: M Z
authors.initials: MZ
authors.lastname: Gendo
authors.forename: R
authors.initials: R
authors.lastname: Haider
authors.forename: K A K
authors.initials: KA
authors.lastname: Abdullah
authors.forename: A
authors.initials: A
authors.lastname: Hassan
authors.forename: F A M
authors.initials: FA
authors.lastname: Shaheen
mesh_terms: D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy; D011086:Polycythemia / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D017678:Sex Distribution
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D007166:Immunosuppressive Agents