The Interaction between Post-Transplant Anemia and Allograft Function in Kidney Transplantation

Y. Kakuta¹, M. Okumi¹, T. Kanzawa¹, K. Unagami², H. Ishida², K. Tanabe¹

¹Urology, Tokyo Women's Medical University, Tokyo, Japan, ²Organ Transplant Medicine, Tokyo Women's Medical University, Tokyo, Japan

Meeting: 2019 American Transplant Congress

Abstract number: C84

Keywords: Kidney transplantation

Session Information

Session Name: Poster Session C: Kidney Complications: Late Graft Failure

Session Type: Poster Session

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Post-transplant anemia (PTA) is one of the common complications, which was observed in about 30% to 40% of kidney transplant recipients. The interaction effect of PTA with other factors including allograft function has not been evaluated directly. We evaluated whether PTA would have interactions with other various important factors including estimated glomerular filtration rate (GFR).

*Methods: We analyzed data using 1307 adult kidney transplant recipients who received tacrolimus (TAC), mycophenolate mofetil (MMF), and methlprednisolone (MP) from 2000 to 2015. The primary endpoint was graft failure (non-censored for death). To determine the impact of hemoglobin (Hb) on graft failure (non-censored for death), time-dependent Cox model was used. To evaluate interactions, subgroup analysis was applied.We defined anemia as hemoglovin (Hb) <12g/dL for women and <13g/dL for men according to WHO / AST criteria.

*Results: The prevalence of anemia in entire population at 7 years after transplantation was 43.6%. There were no significant differences in MP dose, TAC trough level, and MMF dose between the no PTA group and PTA groups. Recipients in the PTA group were more likely to receive erythropoiesis stimulating agent (ESA) and supplement, rennin-angiotensin system blocking agent in contrast to those in no PTA group. Lower Hb (per 1g/dL) considering the time-varying effect was associated with an increased risk of graft failure rate (hazard ratio=1.83, 95%CI 1.66 to 2.02, p<0.001). Time-averaged estimated GFR (TA-eGFR) showed the interaction effect to the Hb. There was a total of 96 graft failures consisting of 8 (1.7%) in the no PTA group and 88 (10.5%) in the PTA group during the follow-up duration. In high TA-eGFR group, the 7-year cumulative graft failure rates were 1.8% in the no PTA group and 7.7% in the PTA group. With the low TA-eGFR group, the corresponding rates were 2.1% and 19.9%, respectively.

*Conclusions: PTA is likely to affect kidney graft failure by interaction with the allograft function. Our findings implied that we should take into account not only Hb levels but also allograft function while determining the treatment strategy for PTA.

To cite this abstract in AMA style:

Kakuta Y, Okumi M, Kanzawa T, Unagami K, Ishida H, Tanabe K. The Interaction between Post-Transplant Anemia and Allograft Function in Kidney Transplantation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/the-interaction-between-post-transplant-anemia-and-allograft-function-in-kidney-transplantation/. Accessed May 9, 2025.

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