Predictive factors for anemia six and twelve months after orthotopic liver transplantation

Transplantation. 2006 Jun 15;81(11):1525-31. doi: 10.1097/01.tp.0000209602.54351.a6.

Abstract

Background: The aim of our study was to determine the prevalence and predictive factors for post-transplant anemia (PTA) at 6 (M6) and 12 (M12) months after orthotopic liver-transplant (OLT) in a cohort of 97 consecutive patients.

Methods: Anemia was defined at M6 and M12 according to the World Health Organization criteria, i.e., a hemoglobin level of <12 g/dL for women and <13 g/dL for men. Immunosuppression relied on tacrolimus and steroids with or without mycophenolate mofetil.

Results: Anemia was present in 64.5%, 50%, and 52.8% of patients before OLT and at M6 and M12, respectively. Of the anemic patients, 33% (M6) and 30.3% (M12) received recombinant erythropoietin therapy. In multivariate analysis, the independent predictive factors for anemia at M6 were mean corpuscular volume (<85 fl) at day 7, daily steroid dosage (<0.3 mg/kg), serum creatinine (>130 micromol/L), and hemoglobin level (<11 g/dL) 1 month after OLT (M1). Independent predictive factors for anemia at M12 were daily steroid dosage at M1 (<0.3 mg/kg), hematocrit at M1 (<33%), red blood cell count at M6 (<3.75 T/L), daily dosage at M1 of cyclosporine and tacrolimus, and OLT for causes other than alcohol abuse.

Conclusion: Anemia is highly prevalent within the first year post-OLT. This deserves further investigation and appropriate treatment.

MeSH terms

  • Adult
  • Anemia / blood
  • Anemia / diagnosis
  • Anemia / etiology*
  • Creatinine / blood
  • Cyclosporine / therapeutic use
  • Erythrocyte Count
  • Erythropoietin / therapeutic use
  • Female
  • Graft Rejection / drug therapy
  • Graft Rejection / prevention & control
  • Hemoglobins / analysis
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Liver Transplantation* / immunology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications / blood
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology*
  • Predictive Value of Tests
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Tacrolimus / therapeutic use
  • Time Factors

Substances

  • Hemoglobins
  • Immunosuppressive Agents
  • Erythropoietin
  • Cyclosporine
  • Creatinine
  • Tacrolimus