Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Transplant Rev (Orlando). 2010 Apr;24(2):89-98. doi: 10.1016/j.trre.2010.01.006.
Posttransplantation anemia (PTA) is a prevalent sequela of solid organ transplantation and a potential independent risk factor for cardiovascular morbidity and mortality in kidney transplant recipients. There are multiple causes of PTA, some of which are associated with early phase anemia (<6 months), whereas others more often induce anemia in the late posttransplant phase (>6 months). Although impaired kidney function contributes to PTA, it is only one of many factors that result in anemia in transplant recipients. Other causes include iron deficiency, medications, infections, acute rejection, inflammation, and erythropoietin deficiency. Unlike in the predialysis chronic kidney disease population, the impact of anemia after kidney transplantation outcomes is unknown. This is in large part due to the absence of controlled trials that address whether correction of anemia improves allograft function or patient morbidity and mortality. Current guidelines recommend evaluation for hemoglobin level of less than 12 g/dL and treatment when the value falls less than 11 g/dL and a target of 11 to 12 g/dL. Additional treatments may entail removing the cause of the anemia, nutritional supplementation, and/or an erythrocyte stimulating agent.
移植后贫血（PTA）是实体器官移植的常见后遗症，也是肾移植受者心血管发病率和死亡率的潜在独立危险因素。PTA 有多种原因，其中一些与早期贫血（<6 个月）有关，而另一些则更常导致移植后晚期贫血（>6 个月）。尽管肾功能受损会导致 PTA，但它只是导致移植受者贫血的众多因素之一。其他原因包括缺铁、药物、感染、急性排斥反应、炎症和促红细胞生成素缺乏。与透析前慢性肾脏病患者不同，肾移植后贫血对结局的影响尚不清楚。这在很大程度上是由于缺乏控制试验来解决纠正贫血是否改善移植物功能或患者发病率和死亡率的问题。目前的指南建议评估血红蛋白水平<12 g/dL，并在值低于 11 g/dL 时进行治疗，目标值为 11 至 12 g/dL。其他治疗方法可能需要消除贫血的原因、营养补充和/或红细胞刺激剂。
