Transplant Outcomes Unaffected by High-Dose Erythropoietin

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High-dose erythropoietin has no significant effect on short- or long-term graft function in renal transplant patients who had chronic kidney disease (CKD) after receiving a deceased donor organ, according to a new study.

A German research team led by Danilo Fliser, MD, of Saarland University Medical Centre in Homburg/Saar, conducted a prospective double-blind study of patients who had chronic kidney disease after receiving a deceased donor kidney, randomizing subjects to receive either three doses of 40,000 units of recombinant human erythropoietin or placebo.

At six weeks and 12 months, the 44 patients in the erythropoietin arm and 44 in the placebo arm did not differ significantly with respect to estimated glomerular filtration rate (46.6 vs. 46.8 and 40.6 vs. 43.6 mL/min/1.73 m2, respectively) and the incidence of delayed graft function (23% vs. 32%, respectively), the investigators reported online ahead of print in Kidney International.

Patient survival for the erythropoietin and placebo groups was similar at six weeks (100% for both arms) and 12 months (98% vs. 95%, respectively). Graft survival also was comparable at six weeks (91% vs. 100%) and 12 months (89% vs. 82%, respectively).

The number and severity of adverse events were similar for both groups, according to the researchers.

They noted that the rationale for the study arose from findings of experimental studies in which administration of erythropoietin protected against against ischemia-reperfusion injury in rodents.

Although it is possible that the erythropoietin dose used in the study was too low to offer this protection after kidney transplantation, the authors pointed out, it was comparable to the doses used in various experimental models of acute kidney injury, including ischemia-reperfusion injury.

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