[Chronic anemia in heart transplant patients: prevalence, predisposing factors and prognostic significance].
OBJECTIVE
Data on chronic anemia following heart transplantation (HT) are scarce and contradictory. Our aims were to determine the prevalence of chronic anemia after HT, to identify predisposing factors for the condition at 12 months, and to evaluate its influence on medium-term and long-term survival.


METHODS
Retrospective analysis of patients who underwent HT between 1991 and 2005 (n=457). Chronic anemia was defined as a hemoglobin level <12 g/dL.


RESULTS
The prevalence of post-HT chronic anemia was 75.5% at 1 month, 31% at 12 months, and 26.2% at 120 months. The condition was significantly more prevalent among women than men. Predisposing factors for chronic anemia 1 year post-HT were mild-to-moderate chronic renal failure (i.e., creatinine level >1.5 mg/dL; odds ratio [OR]=2.8; 95% confidence interval [CI], 1.5-5.0), female sex (OR=6.4; 95% CI, 3.1-13.2), and immunosuppression with mycophenolate mofetil compared with azathioprine (OR=2.6;, 95% CI, 1.4-4.8). The prevalence of chronic anemia 12 months after HT was independent of the donor's sex, the recipient's age, the etiology of the recipient's heart failure, diabetes mellitus, mild-to-moderate graft rejection, cytomegalovirus infection, and angiotensin-converting enzyme inhibitor treatment. The presence of chronic anemia 12 months after HT did not influence either long-term survival (mean, 11.5 years with chronic anemia vs. 13.0 years without) or actuarial survival.


CONCLUSIONS
Post-HT chronic anemia is common, but improves with time and treatment. Predisposing factors for the condition 1 year post-HT include chronic renal failure, female sex, and immunosuppression with mycophenolate mofetil. The presence of chronic anemia does not appear to influence long-term survival.
Cursack
Guillermo C
GC
Area del Corazón. Complejo Hospitalario Universitario Juan Canalejo, A Coruña, España.
Crespo-Leiro
María G
MG
Paniagua-Martín
María J
MJ
Muñiz
Javier
J
Naya
Carmen
C
Grille
Zulaika
Z
Rodríguez
José A
JA
Marzoa
Raquel
R
Barge
Eduardo
E
Ríos
Ramón
R
Estévez
Francisco
F
Cuenca
José J
JJ
Juffé-Stein
Alberto
A
Castro-Beiras
Alfonso
A
D000740:Anemia / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D015984:Causality; D002908:Chronic Disease; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors