Abstract: TH-PO971
Medication Evaluation of Early Post-Transplant Anemia Management
Session Information
- Anemia in CKD: Risk Factors, Practice Patterns, Therapies
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 200 Anemia and Iron Metabolism
Authors
- Yanqui, Estefany, University of Cincinnati Health, Cincinnati, Ohio, United States
- Kluener, Allyson M., University of Cincinnati Health, Cincinnati, Ohio, United States
- Parrish, Nicholas J., University of Cincinnati Health, Cincinnati, Ohio, United States
- Cuffy, Madison, University of Cincinnati Health, Cincinnati, Ohio, United States
- Govil, Amit, University of Cincinnati Health, Cincinnati, Ohio, United States
Background
Post-transplant anemia (PTA) is a common phenomenon in kidney transplant recipients (KTR). There are currently no consensus guidelines for PTA, however patients are commonly treated with erythropoiesis-stimulating agents and receive iron deficiency correction. Dosing and duration for these regimens remain unclear. The purpose of this study is to evaluate the efficacy of erythropoietin use and intravenous iron supplementation on hemoglobin in KTR with PTA.
Methods
This is a single center, retrospective cohort study from 10/1/2021 – 4/1/2022. Primary outcome was hemoglobin at 6 months in KTR who received ESA, iron sucrose or neither. Secondary outcomes included kidney function, iron studies, transfusions, dapsone use > 7 days post-transplant. All continuous data was analyzed using a student T-test. All categorical data was analyzed using a chi square test.
Results
Ninety-seven KTR were included in our final analysis. A total of 59 (60.8%) of KTR received either ESA alone or in combination with IV iron. Hemoglobin and renal function trends over time are represented on Figure 1 and 2. Of note, 16 (42.1%) of the patients who did not receive ESA or IV iron were living donor transplant recipients. There was no difference in hemoglobin outcomes at 6 months in patients who received IV iron repletion with ESA versus ESA alone (Figure 3). Patients who received IV iron < POD 30, had significantly higher Hgb outcomes than those who got IV iron >POD 30 (Figure 4). Dapsone use >7 days was associated with significantly reduced Hgb during the duration of use (Figure 5).
Conclusion
Patients with PTA did not show additional hemoglobin increases when given any ESA as compared to those who received no ESA. Differences in treatment groups including higher numbers of deceased donors and poor graft function may have contributed to the poor response to ESA. A prospective, randomized study is warranted for the best use of these interventions in a judicious manner.