Taegtmeyer Anne B, Rogers Paula, Breen Jane B, Barton Paul J, Banner Nicholas R, Yacoub Magdi H
Transplant Unit, Harefield Hospital, Harefield, Middlesex, United Kingdom.
J Heart Lung Transplant. 2008 Apr;27(4):394-9. doi: 10.1016/j.healun.2008.01.014.
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.
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.
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.
Anemia before, but not after transplantation, is a common independent predictor of 1-year survival in cardiac transplant patients.
