A Descriptive Study of Erythrocytosis Post Kidney Transplant, A Single Center Experience

Abstract

ABSTRACT:BACKGROUND :Post Transplant Erythrocytosis (PTE) is relatively a common complication following renal transplantation, occurs in 8 to 15 percent of renal transplant recipients ,it is mainly due to adequate production of erythropoietin by the transplanted graft and elimination of bone marrow inhibitors attending the uremic symptoms.OBJECTIVE:This study was conducted to know the prevalence, manifestation , and risk factors of Post Transplant Erythrocytosis (PTE).PATIENTS AND METHODS:This is an observational retrospective study enrolled 290 patients who underwent kidney transplantation and followed up at The Nephrology and kidney transplantation Center, Medical City Baghdad , The data used in this study were collected from the patients, their medical records and from the laboratory. The follow up period was from the third months post transplant to the end of first year. These data include ( name, age, sex ,weight, etiology of chronic renal failure, duration of hemodialysis before transplantation, the use of erythropoietin stimulating agent, living kidney donor (related or unrelated), The use of basilixmab or Anti Thymocyt Globulin) at induction, the calcineurine inhibitor ( cyclosporine or tacrolimus), the occurrence of acute rejection, the type of antihypertensive used post transplant .Laboratory data include ,hemoglobin level, red blood cells packed volume, serum creatinine .RESULT : Twenty three patients (7.9%) had erythrocytosis post kidney tranplantation with Hemoglobin level of 17.5 g/dl (17 -17.9) and PCV of 54 % (52.1 – 54.4). Only two patients (8.7 % ) had cerebrovascular accident. From the non transplant related parameters, hypertension was significantly associated with PTE ( P Value of 0.026 ). While the others ( age , gender, weight , etiology of the ESRD and the duration of dialysis) showed no significant association. From the transplant related parameters, low serum creatinine (0.8-1.2mg/dl) showed significant association with PTE (P value <0.0001). Also both hypertension and the use of Beta blocker shows significant association (P value <0.05)CONCLUSION:Post transplant erythrocytosis occurs in about eight percent of kidney transplant recipient, it may be asymptomatic or complicated by thrombotic event, and it is associated with lower serum creatinine and hypertension..