title: The effects of pre- and post-transplant anemia on 1-year survival after cardiac transplantation.
abstract: BACKGROUND
  Anemia is associated with a poor prognosis in heart failure. Recent studies have also suggested that anemia may be a predictor of survival after heart transplantation.
  
  
  METHODS
  We investigated whether anemia before or after orthotopic cardiac transplantation affected post-transplant survival and analyzed data from a historical cohort of 267 consecutive adult patients who underwent transplantation between 1994 and 1999. Hemoglobin levels immediately before and at 6 weeks after orthotopic cardiac transplantation were recorded. Anemia was defined as a hemoglobin level less than 12 g/dl. The outcome was all-cause mortality. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards models.
  
  
  RESULTS
  Pre-transplant anemia was present in 26% (n= 70). One-year survival was 70% in subjects who were anemic before transplantation compared with 81% in those who were not (p = 0.03). Multivariate analysis showed a 1-year mortality hazard ratio for pre-transplant anemic subjects of 1.77 (95% confidence interval, 1.03 3.0, p = 0.038). Anemia was more prevalent after transplantation (78%). There was no difference in 1-year survival between post-transplant anemic and non-anemic subjects.
  
  
  CONCLUSIONS
  Anemia before, but not after transplantation, is a common independent predictor of 1-year survival in cardiac transplant patients.
authors: Transplant Unit, Harefield Hospital, Harefield, Middlesex, United Kingdom.
authors: Anne B
authors: AB
authors: Taegtmeyer
authors: Paula
authors: P
authors: Rogers
authors: Jane B
authors: JB
authors: Breen
authors: Paul J
authors: PJ
authors: Barton
authors: Nicholas R
authors: NR
authors: Banner
authors: Magdi H
authors: MH
authors: Yacoub
mesh_terms: D000328:Adult; D000740:Anemia / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000601:surgery*; D016027:Heart Transplantation / Q000401:mortality; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D006454:Hemoglobins