Post-transplant anemia (PTA) likely influences the risk of graft failure, according to investigators presenting at the American Transplant Congress.

In an analysis of data from 1307 adult kidney transplant recipients, 43.6% had PTA at 7 years after transplantation, Yoichi Kakuta, MD, of Tokyo Women’s Medical University, and collaborators reported. Of the 96 graft failures, 88 occurred in the PTA group and 8 in the no PTA group. A 1 g/dL reduction in hemoglobin was associated with a significant 1.8-fold increase in graft failure.

PTA showed an interaction with time-averaged estimated glomerular filtration rate (eGFR). For recipients with a high eGFR, the 7-year cumulative graft failure rate was 7.7% in the PTA group vs 1.8% in the no PTA group. For those with low eGFR, the rates were 19.9% vs 2.1%, respectively.

The investigators observed no significant differences in dose of methylprednisolone or mycophenolate mofetil or in tacrolimus trough level by patients’ anemia status. Anemic recipients were more likely to receive erythropoiesis stimulating agents (ESA) and renin-angiotensin system blockers.

“Our findings implied that we should take into account not only Hb levels but also allograft function while determining the treatment strategy for PTA,” Dr Kakuta and the team concluded in their study abstract.

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Kakuta Y, Okumi M, Kanzawa T, et al. The interaction between post-transplant anemia and allograft function in kidney transplantation. Presented at the 2019 American Transplant Congress in Boston. Abstract C84.