Department of Cardiology, Oslo University Hospital, Oslo, Norway.
University of Oslo, Oslo, Norway.
Clin Transplant. 2021 Aug;35(8):e14346. doi: 10.1111/ctr.14346. Epub 2021 May 28.
Optimal iron management is crucial to marginal patients such as heart transplant recipients. As inflammatory mechanisms are present in transplant recipients, the definition of iron deficiency used in the general population might not be appropriate.
To evaluate the prevalence and determinants of iron deficiency in Norwegian heart transplant recipients.
We consecutively assessed iron parameters in all Norwegian heart transplant recipients at their annual follow-up. Several definitions of iron deficiency suggested in the literature were assessed: ferritin <100 µg/L, or ferritin 100-300 µg/L combined with transferrin saturation of <20% (ID ); ferritin <100 µg/L (ID ); transferrin saturation of <20% (ID ), and ferritin <30 µg/L (ID ).
179 of 378 heart transplant recipients (47%) had iron deficiency defined as ID . 152 patients (40%) had ID , and 103 patients (27%) had ID . 17 patients (5%) had ID . 88 patients (23%) had a C-reactive protein (CRP) >5.0 µg/L.
Iron deficiency defined as ID , ID or ID is prevalent in the heart transplant population, while ID is not. Further research is required to identify the mechanisms of iron homeostasis in heart transplant recipients and to establish a definition of iron deficiency suitable for this population.
对于边缘患者(如心脏移植受者)而言,最佳的铁管理至关重要。由于移植受者存在炎症机制,因此在一般人群中使用的缺铁定义可能并不适用。
评估挪威心脏移植受者中铁缺乏的患病率和决定因素。
我们连续评估了所有在年度随访时的挪威心脏移植受者的铁参数。评估了文献中提出的几种缺铁定义:铁蛋白<100μg/L,或铁蛋白 100-300μg/L 合并转铁蛋白饱和度<20%(ID);铁蛋白<100μg/L(ID);转铁蛋白饱和度<20%(ID)和铁蛋白<30μg/L(ID)。
179/378 例(47%)心脏移植受者的铁缺乏定义为 ID。152 例(40%)患者有 ID,103 例(27%)患者有 ID,17 例(5%)患者有 ID,88 例(23%)患者 C 反应蛋白(CRP)>5.0μg/L。
在心脏移植人群中,ID、ID 或 ID 定义的缺铁很常见,而 ID 则不然。需要进一步研究以确定心脏移植受者中铁稳态的机制,并为该人群建立适合的缺铁定义。