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Post-Liver Transplantation Anemia and Its Correlation with Mortality and Graft Failure

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Abstract

Background

In adults, post-liver transplantation anemia (PLTA) is common, but its characteristics and long-term influence on major outcomes have yet to be elucidated.

Aim

We aimed to assess prevalence, characteristics, predictors, and outcomes of PLTA at 6 months (early PLTA) and at 2 years (late PLTA).

Methods

A single-center retrospective cohort study using prospectively collected data from liver transplantations in adults during January 2007–December 2015. PLTA impact on various long-term outcomes was assessed, including mortality, composites of mortality or graft failure, cardiovascular outcomes, and malignancy occurrences.

Results

Hundred and fifty liver transplanted individuals were included. There was a 79% prevalence of anemia pre-transplantation, whereas early and late PLTA were evident in 58% and 40% of patients, respectively. Pre-transplantation anemia was associated with development of early PLTA which was associated with late PLTA. In a multivariate analysis, early PLTA was significantly associated with mortality or graft failure at a follow-up of 3 years (odds ratio 3.838, 95% CI 1.114–13.226). Late PLTA was not significantly associated with worse long-term outcomes.

Conclusions

Early and late PLTA are prevalent among liver transplanted patients. Early PLTA is associated with long-term mortality or graft failure.

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References

  1. Qamar AA, Grace ND, Groszmann RJ, et al. Incidence, prevalence, and clinical significance of abnormal hematologic indices in compensated cirrhosis. Clin Gastroenterol Hepatol. 2009;7:689–695.

    Article  Google Scholar 

  2. Gonzalez-Casas R, Jones EA, Moreno-Otero R. Spectrum of anemia associated with chronic liver disease. World J Gastroenterol. 2009;15:4653–4658.

    Article  CAS  Google Scholar 

  3. Lesurtel M, Raptis DA, Melloul E, et al. Low platelet counts after liver transplantation predict early posttransplant survival: the 60-5 criterion. Liver Transpl. 2014;20:147–155.

    Article  Google Scholar 

  4. Takahashi K, Nagai S, Putchakayala KG, et al. Prognostic impact of postoperative low platelet count after liver transplantation. Clin Transpl. 2017;31:e12891.

    Article  Google Scholar 

  5. WHO Scientific Group on Nutritional Anaemias & World Health Organization. Nutritional anaemias: report of a WHO scientific group [meeting held in Geneva from 13 to 17 March 1967]; 1968.

  6. Gafter-Gvili A, Ayalon-Dangur I, Cooper L, et al. Posttransplantation anemia in kidney transplant recipients: a retrospective cohort study. Medicine. 2017;96:e7735.

    Article  Google Scholar 

  7. Vanrenterghem Y, Ponticelli C, Morales JM, et al. Prevalence and management of anemia in renal transplant recipients: a European survey. Am J Transpl. 2003;3:835–845.

    Article  Google Scholar 

  8. Auerbach M, Adamson JW. How we diagnose and treat iron deficiency anemia. Am J Hematol. 2016;91:31–38.

    Article  Google Scholar 

  9. Carmel R. Current concepts in cobalamin deficiency. Annu Rev Med. 2000;51:357–375.

    Article  CAS  Google Scholar 

  10. Antony AC. Megaloblastic anemias. In: Ronald Hoffman M, Jr Benz EJ, Silberstein LE, Heslop H, Weitz J, Anastasi J, eds. Hematology: Edition Basic Principles and Practice. 7th ed. Philadelphia: Elsevier; 2018.

    Google Scholar 

  11. Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE. The impact of anemia on cardiomyopathy, morbidity, and mortality in end-stage renal disease. Am J Kidney Dis. 1996;28:53–61.

    Article  CAS  Google Scholar 

  12. Ezekowitz Justin A, McAlister Finlay A, Armstrong Paul W. Anemia is common in heart failure and is associated with poor outcomes. Circulation. 2003;107:223–225.

    Article  CAS  Google Scholar 

  13. Kew MC, Fisher JW. Serum erythropoietin concentrations in patients with hepatocellular carcinoma. Cancer. 1986;58:2485–2488.

    Article  CAS  Google Scholar 

  14. Misra S, Moore TB, Ament ME, Vargas JH, Busutill RW, McDiarmid SV. Profile of anemia in children after liver transplantation. Transplantation. 2000;70:1459–1463.

    Article  CAS  Google Scholar 

  15. Ndimbie OK, Frezza E, Jordan JA, Koch W, van Thiel DH. Parvovirus B19 in anemic liver transplant recipients. Clin Diagn Lab Immunol. 1996;3:756–760.

    Article  CAS  Google Scholar 

  16. Ducroux E, Boillot O, Ocampo MA, et al. Skin cancers after liver transplantation: retrospective single-center study on 371 recipients. Transplantation. 2014;98:335–340.

    Article  Google Scholar 

  17. Spivak JL. Cancer-related anemia: its causes and characteristics. Semin Oncol. 1994;21:3–8.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was performed in partial fulfillment of Iddo Reisler’s M.D. thesis requirements at the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

Funding

The authors declare no funding received for this work.

Author information

Authors and Affiliations

  1. Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel

    Tamar Berger, Pia Raanani & Anat Gafter-Gvili

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Tamar Berger, Iddo Reisler, Pia Raanani, Eviatar Nesher, Eytan Mor, Anat Gafter-Gvili & Amir Shlomai

  3. Bio-Statistical Unit, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel

    Tzippy Shochat

  4. Department of Transplantation, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel

    Eviatar Nesher & Eytan Mor

  5. Department of Medicine A, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel

    Anat Gafter-Gvili

  6. Department of Medicine D and the Liver Institute, Rabin Medical Center, Beilinson Hospital, Beilinson Campus, 39 Jabotinsky Street, Petah Tikva, Israel

    Amir Shlomai

Authors
  1. Tamar Berger
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  2. Iddo Reisler
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  3. Tzippy Shochat
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  4. Pia Raanani
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  8. Amir Shlomai
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Corresponding author

Correspondence to Amir Shlomai.

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Supplementary Figure 1. Study design and population (TIFF 11081 kb)

10620_2019_6021_MOESM2_ESM.tif

Supplementary Figure 2. Hemoglobin and MCV dynamics over time from transplantation for the entire cohort (n = 150) (TIFF 11474 kb)

Supplementary material 3 (DOCX 13 kb)

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Berger, T., Reisler, I., Shochat, T. et al. Post-Liver Transplantation Anemia and Its Correlation with Mortality and Graft Failure. Dig Dis Sci 65, 3040–3051 (2020). https://doi.org/10.1007/s10620-019-06021-7

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  • DOI: https://doi.org/10.1007/s10620-019-06021-7

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