Division of Nephrology, University of Miami, Coral Gables, FL.
Division of Nephrology, University of Florida, Gainesville, FL.
Am J Transplant. 2010 Apr;10(4):938-942. doi: 10.1111/j.1600-6143.2010.03012.x. Epub 2010 Feb 10.
Posttransplant erythrocytosis (PTE) poses a potential risk of thrombosis in kidney transplantation. Clinical observation of our systemically drained simultaneous kidney pancreas transplant (S-SPK) patients showed a higher incidence of PTE and need for phlebotomies. To evaluate the incidence of PTE we analyzed hematocrit (Hct) levels and frequency of phlebotomies in 94 SPK as compared to 174 living donor (LD) recipients and 53 type-I diabetic with kidney transplant only. For study purposes we defined PTE as Hct >50% or the necessity for phlebotomies. Kaplan-Meier plots and Cox proportional hazard models were used to examine the association between the transplant type and PTE. We found an increased incidence of PTE in SPK compared to LD (p < 0.001). In the multivariate model, SPK had a 5-fold risk for the development of PTE (AHR 5.3, 95% CI 1.8, 15.9). The incidence of therapeutic phlebotomy was 13% among SPK patients and 4% in LD kidney recipients; 19 patients altogether. A total of 64 units were phlebotomized (48-SPK and 16-LD). Type I diabetic patients with a kidney transplant showed a 0% incidence of PTE. We observed a greater incidence of PTE and phlebotomies in S-SPK compared to LD with kidney only transplant recipients.
移植后红细胞增多症（PTE）会增加肾移植后血栓形成的风险。我们对系统性引流的胰肾联合移植（S-SPK）患者的临床观察显示，PTE 的发生率较高，需要进行放血治疗。为了评估 PTE 的发生率，我们分析了 94 例 SPK 患者、174 例活体供肾（LD）受者和 53 例仅接受肾移植的 1 型糖尿病患者的血细胞比容（Hct）水平和放血治疗的频率。为了研究目的，我们将 Hct>50%或需要放血治疗定义为 PTE。采用 Kaplan-Meier 图和 Cox 比例风险模型来检验移植类型与 PTE 之间的关联。我们发现与 LD 相比，SPK 的 PTE 发生率更高（p<0.001）。在多变量模型中，SPK 发生 PTE 的风险增加了 5 倍（AHR 5.3，95%CI 1.8，15.9）。SPK 患者的治疗性放血治疗发生率为 13%，LD 肾移植受者为 4%；共有 19 例患者需要放血治疗。总共进行了 64 个单位的放血治疗（48 例 SPK，16 例 LD）。仅接受肾移植的 1 型糖尿病患者 PTE 发生率为 0%。与仅接受肾移植的 LD 受者相比，我们观察到 S-SPK 的 PTE 和放血治疗发生率更高。
