The pre-transplant anemic condition is independent of long-term outcome in living-related kidney transplantation

Abstract

The relationship between pre-transplant Hemoglobin (Hb) concentration and long-term outcome of living-related kidney transplantation is far from well addressed. A retrospective cohort study was conducted by reviewing the medical profile of the patients who received living-related kidney transplantations at our center from January 2006 to January 2013. Patients were divided into two groups: high Hb group (10 g/dL) and low Hb group (<10 g/dL). Cox regression model was utilized to analyze the effect of pre-transplant hemoglobin concentration on the patient and graft survival. About 422 patients were of Hb level <10 g/dL (78.30 ± 14.18 g/dL), 280 were >10 g/dL (116.2 ± 14.43 g/dL) (p < 0.001). In a follow-up of 35.34 ± 18.12 months, we did not find any difference in serum creatinine between the two groups. Low Hb concentration is not associated with increased risk of developing DGF (HR = 1.186, 95% CI: 0.53-2.654), acute rejection (HR = 1.338, 95% CI: 0.919-1.947), overall infection (HR = 1.263, 95% CI: 0.847-1.885) nor perioperational infection (HR = 1.019, 95% CI: 0.513-2.026). Though we detected a trend that low Hb level group were of higher incidence of patient death and graft failure, the two groups did not differ significantly (2.38% vs. 0.71%, p = 0.096; and 4.04% vs. 2.14%, p = 0.165, respectively). Cox regression model revealed that pre-transplant Hb level <10 g/dL was independent of increased overall mortality (HR = 3.379; 95% CI: 0.706-17.172) and increased death censored allograft failure risk (HR = 1.556; 95% CI: 0.595-4.069). Pre-transplant Hb concentration <10 g/dL is independent of poor long-term outcome of living-related kidney transplantation. © 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted.