Session Name: Poster Session D: Kidney: Acute Rejection
Session Type: Poster Session
Date: Tuesday, May 5, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Background: The correction of anemia has been associated with improved kidney allograft outcomes. Recently, erythropoietin was shown to directly suppress alloreactive human T-cells by inhibiting the biochemical signaling pathway of the T-cell receptor, and IL-2 receptor. To examine the potential immunosuppressive role of erythropoietin, we evaluated the incidence of acute cellular rejection in relation to darbepoetin administration in kidney transplant recipients.
Methods: We performed a retrospective review of kidney transplant recipients at our transplant center from 2010 to 2013. All renal transplant recipients over a 36 month period were included. Data involving the administration and dosage of darbepoetin was included in the analysis.
Results: A total of 395 transplant recipients were included in this review. Patient characteristics included: median age 53 (range 18-80); 54% male; 46% Caucasian, 27% African American, 24% Hispanic; 46% received induction therapy. Median post transplant follow up was 3 years (range 1 -5 years). 169 patients received 1 or more doses of darbepoetin. 61 patients received only one dose, 68 patients received 2 to 4 doses, 29 patients received 5 to 9 doses, and 11 patients required 10 or more doses. Requirement of 5 or more doses of darbepoetin was significantly associated with acute cellular rejection (p = 0.003) and occurred more frequently in females (p = 0.004) and African Americans (p < 0.001).
In multivariate logistic regression analysis, patients who received 5 or more dosages of darbepoetin were more likely to develop acute cellular rejection with an odds ratio of 2.44, (95% CI 1.17 5.08, p = 0.017). This increased risk was independent of patient age, gender, race, whether they received induction therapy, or type of induction agent used.
Conclusion: Persistent anemia, requiring 5 or more doses of darbepoetin, is an independent predictor of acute cellular rejection in kidney transplant recipients.
To cite this abstract in AMA style:Fischbach B, Gonzalez S, Yango A, Chandrakantan A, Rajagopal A, Rice K, Melton L, Barri Y, Saim M, Onaca N, Ruiz R, Levy M, Klintmalm G. The Immunosuppressive Effects of Erythropoietin Do Not Confer Lower Rates of Acute Rejection in Post Kidney Transplant Recipients Receiving Darbepoetin [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/the-immunosuppressive-effects-of-erythropoietin-do-not-confer-lower-rates-of-acute-rejection-in-post-kidney-transplant-recipients-receiving-darbepoetin/. Accessed December 6, 2023.
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