Alotaibi Nouf E, Mohsin Bilal, Alharbi Shoroug, Odah Nasser O, Sindi Douaa, Bargawi Sarah, Abid Raghad B, Simsim Mohammed, Alqurashi Aboud, Badawi Mustafa, Alshehail Bashayer, Alotaibi Abdulmalik
Umm Al-Qura university, Clinical pharmacy department, College of pharmacy, Makkah, Saudi Arabia.
King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia.
Saudi Pharm J. 2023 Aug;31(8):101696. doi: 10.1016/j.jsps.2023.101696. Epub 2023 Jul 7.
Post-transplant anemia (PTA) is a common serious complication following kidney transplantation. It affects graft and patient survival. Anemia that presents within six months post-transplantation is defined as an early PTA. Late PTA is when anemia occurs more than six months following transplantation. Despite this, there are limited studies on the long-term impact of anemia on patient survival and graft function in kidney transplants. We conducted a retrospective study with long-term follow-up to investigate the effect of early and late PTA on patient and graft function within seven years and to estimate the prevalence of PTA at six months, two, four, and seven years postrenal transplantation along with the associated risk factors.
A retrospective chart review of 145 adult patients who had kidney transplants from January 1 to December 31, 2015, and were followed up until December 31, 2022. Anemia was defined according to the World Health Organization (WHO) criteria of hemoglobin<12 gm/dl in females and<13 mg/dl in males. Pretransplant, six months, two, four, and seven years postrenal transplantation medications and laboratory data were obtained. Patients were excluded if they were pediatrics or had missing data.
180 patients were screened, and 145 patients met the inclusion criteria. The prevalence of early PTA was 8.3%. Trimethoprim-sulfamethoxazole was significantly associated with anemia within six months. The prevalence of anemia increased at two, four-, and seven-years post-transplant (24.8%, 24.8%, and 27.6%, respectively). Graft failure was significantly associated with late PTA at four and seven years (p-value < 0.001). P < 0.005, respectively). Death was reported for 3 patients, and it was significantly associated with late transplant anemia (p-value < 0.005), Cytomegalovirus was associated with anemia at 6 months and 2 years post-transplant and significantly associated with graft failure (p-value < 0.037).
The results of this study indicate that post-transplant anemia is associated with graft failure and patient mortality. Therefore, managing anemia post-transplant should be addressed more carefully.
移植后贫血（PTA）是肾移植后常见的严重并发症。它会影响移植物和患者的存活。移植后六个月内出现的贫血被定义为早期PTA。晚期PTA是指移植后六个月以上出现的贫血。尽管如此，关于贫血对肾移植患者存活和移植物功能的长期影响的研究有限。我们进行了一项长期随访的回顾性研究，以调查早期和晚期PTA对患者和移植物功能在七年内的影响，并估计肾移植后六个月、两年、四年和七年时PTA的患病率以及相关危险因素。
对2015年1月1日至12月31日接受肾移植且随访至2022年12月31日的145例成年患者进行回顾性病历审查。贫血根据世界卫生组织（WHO）标准定义，即女性血红蛋白<12 gm/dl，男性血红蛋白<13 mg/dl。获取移植前、肾移植后六个月、两年、四年和七年的用药及实验室数据。如果患者是儿科患者或有缺失数据，则将其排除。
共筛选出180例患者，145例符合纳入标准。早期PTA的患病率为8.3%。甲氧苄啶 - 磺胺甲恶唑与六个月内的贫血显著相关。移植后两年、四年和七年时贫血患病率增加（分别为24.8%、24.8%和27.6%）。移植物失败与四年和七年时的晚期PTA显著相关（p值<0.001）。P<0.005，分别）。报告有3例患者死亡，且与晚期移植后贫血显著相关（p值<0.005），巨细胞病毒与移植后6个月和2年时的贫血相关，且与移植物失败显著相关（p值<0.037）。
本研究结果表明，移植后贫血与移植物失败和患者死亡率相关。因此，应更谨慎地处理移植后贫血问题。
