Przybylowski P, Malyszko J, Glowinska I, Malyszko J, Kozlowska S, Mysliwiec M
Cardiovascular Surgery and Transplantology Department, Collegium Medicum, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
Transplant Proc. 2011 Dec;43(10):3885-7. doi: 10.1016/j.transproceed.2011.08.083.
Functional iron deficiency is characterized by the presence of adequate iron stores as defined by conventional criteria, but insufficient iron mobilization to adequately support erythropoiesis. The aim of this study was to assess the prevalence of functional iron deficiency in heart and kidney transplant recipients based on data from recent medical records.
Using standard laboratory methods obtained during routine checkups, we assessed iron status by determinations of serum iron, total iron-binding capacity, ferritin and total saturation of transferrin (TSAT), as well as complete blood count and creatinine.
Iron parameters were available for 62% of heart transplant recipients, but only for 26% of kidney transplant recipients. Absolute iron deficiency was observed in 35% of the heart and 8% of the kidney transplant recipients (P<.001). Functional iron deficiency was present in 4% of the heart and 6% of the kidney transplant recipients. Functional iron deficiency was associated with significantly higher serum ferritin and lower TSAT. In addition, although their hemoglobin values did not differ significantly, heart transplant recipients with absolute iron deficiency showed lower erythrocyte blood counts, were younger, and had a shorter time after transplantation.
Iron parameters are assessed infrequently, particularly among kidney transplant recipients. Iron deficiency was present in a considerable group of heart transplant recipients. This population should be carefully screened for possible reversible causes of iron deficiency to slow or to minimize anemia development.
功能性缺铁的特征是按照传统标准定义的铁储备充足,但铁动员不足,无法充分支持红细胞生成。本研究的目的是根据近期病历数据评估心脏和肾脏移植受者中功能性缺铁的患病率。
我们使用常规体检期间获得的标准实验室方法,通过测定血清铁、总铁结合力、铁蛋白和转铁蛋白总饱和度(TSAT)以及全血细胞计数和肌酐来评估铁状态。
62%的心脏移植受者有铁参数数据,但肾脏移植受者中只有26%有此类数据。35%的心脏移植受者和8%的肾脏移植受者存在绝对缺铁(P<0.001)。4%的心脏移植受者和6%的肾脏移植受者存在功能性缺铁。功能性缺铁与血清铁蛋白显著升高和TSAT降低相关。此外,尽管血红蛋白值无显著差异,但存在绝对缺铁的心脏移植受者红细胞计数较低、年龄较小且移植后时间较短。
铁参数评估不频繁,尤其是在肾脏移植受者中。相当一部分心脏移植受者存在缺铁。应对这一人群仔细筛查缺铁的可能可逆原因,以减缓或尽量减少贫血的发展。