The Effects of Pre- and Post-transplant Anemia on 1-Year Survival After Cardiac Transplantation

Taegtmeyer, Anne B.; Rogers, Paula; Breen, Jane; Barton, Paul J.R.; Banner, Nicholas R.; Yacoub, Magdi H.

doi:10.1016/j.healun.2008.01.014

Cited by 21 publications

(14 citation statements)

References 25 publications

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“…79 In 267 patients undergoing orthotopic cardiac transplantation, pretransplantation anaemia was present in 26%, and post-transplantation anaemia at 6 weeks in 78%. 80 Survival at 1 year was 70% in individuals who were anaemic before transplantation, and 81% in those who were not (P <0.03). 80 In 105 heart transplantation recipients, iron deficiency was present in 39% after around 8 years of follow-up.…”

Section: Iron In Heart Transplantationmentioning

confidence: 95%

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Iron deficiency and cardiovascular disease

Haehling

Jankowska

Veldhuisen³

et al. 2015

Nat Rev Cardiol

251

151

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Iron deficiency affects up to one-third of the world's population, and is particularly common in elderly individuals and those with certain chronic diseases. Iron excess can be detrimental in cardiovascular illness, and research has now also brought anaemia and iron deficiency into the focus of cardiovascular medicine. Data indicate that iron deficiency has detrimental effects in patients with coronary artery disease, heart failure (HF), and pulmonary hypertension, and possibly in patients undergoing cardiac surgery. Around one-third of all patients with HF, and more than one-half of patients with pulmonary hypertension, are affected by iron deficiency. Patients with HF and iron deficiency have shown symptomatic improvements from intravenous iron administration, and some evidence suggests that these improvements occur irrespective of the presence of anaemia. Improved exercise capacity has been demonstrated after iron administration in patients with pulmonary hypertension. However, to avoid iron overload and T-cell activation, it seems that recipients of cardiac transplantations should not be treated with intravenous iron preparations.

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Section: Iron In Heart Transplantationmentioning

confidence: 95%

“…80 Survival at 1 year was 70% in individuals who were anaemic before transplantation, and 81% in those who were not (P <0.03). 80 In 105 heart transplantation recipients, iron deficiency was present in 39% after around 8 years of follow-up. 81 Iron administration in cardiac transplantation is a double-edged sword.…”

Section: Iron In Heart Transplantationmentioning

confidence: 95%

Iron deficiency and cardiovascular disease

Haehling

Jankowska

Veldhuisen³

et al. 2015

Nat Rev Cardiol

251

151

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“…Iron deficiency is a common cause for anemia in chronic heart failure and associated with an increased mortality when compared with nonanemic patients . Likewise, anemia before cardiac transplantation is associated with a decreased 1‐year survival on the waitlist, but this negative effect of pretransplant anemia did not persist after cardiac transplantation . A clinical trial showed a positive effect of intravenous iron supplementation with ferric carboxymaltose on the functional status, symptoms and the quality of life in patients with heart failure and iron deficiency .…”

Section: Clinical Relevance Of Iron Metabolism In Transplantation Medmentioning

confidence: 99%

Iron metabolism in transplantation

2014

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“…We opted to use WHO criteria [ 23 ] for the definition of anemia [ 13 ]. It seems there is a temporal dependence of the development of anemia with high prevalence postoperatively from 90% at discharge [ 37 ] to 78% six weeks after transplantation [ 38 ] and decrease in the further course when summarizing the few available studies. However, even 115 to 120 months after transplantation, anemia rates of 26% [ 37 ] to 41% [ 13 ] were reported.…”

Section: Discussionmentioning

confidence: 99%

Blood volume and hemoglobin mass in long-term heart transplant recipients with and without Anemia

Seiler

Ahlgrim

Birkner

et al. 2021

J Cardiothorac Surg

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Background In systolic chronic heart failure, a heterogeneous blood volume (BV) regulation can be found with plasma volume expansion in many cases, possibly leading to pseudoanemia. Little is known about the volume status after heart transplantation (HTX). So far, anemia of HTX recipients was solely investigated using hemoglobin-concentration that may be misleading in a clinical context. The objective of the study was whether a difference in plasma volume and red cell volume can be observed in clinically stable heart transplant recipients compared to matched control subjects. Secondary, the aim was to describe anemia in the long-term after HTX based on quantitative data. Methods Blood volume and its constituents red cell volume and plasma volume were quantified using an abbreviated carbon monoxide rebreathing method (aCORM) with focus on its primary measure total hemoglobin mass (Hbmass) and coincidental anemia in 36 (7 women) heart transplant recipients. For comparison, a matched control group of 46 (5 women) healthy subjects was selected. Results Neither Hbmass nor blood volumes were significantly different in HTX patients compared to matched healthy control group subjects. The prevalence of anemia 6.3 ± 4.3 years after transplantation was 19%. Hbmass and red cell volume were significantly lower in anemic HTX patients compared to non-anemic patients while plasma volume was not expanded. Various immunosuppressant regimens did not have an effect on Hbmass, plasma volume or red cell volume. Conclusions There was no difference in blood volumes and Hbmass between HTX patients and control subjects. The pathophysiologic blood volume regulation in chronic heart failure does not seem to be longer active in long-term HTX recipients. However, in the long-term after HTX, anemia occurs in a considerable number of patients as true anemia without a clear association with immunosuppression. Trial registration German registry for clinical studies, DRKS00006078. Registered 09 May 2014, https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID=DRKS00006078.

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The Effects of Pre- and Post-transplant Anemia on 1-Year Survival After Cardiac Transplantation

Cited by 21 publications

References 25 publications

Iron deficiency and cardiovascular disease

Iron deficiency and cardiovascular disease

Iron metabolism in transplantation

Blood volume and hemoglobin mass in long-term heart transplant recipients with and without Anemia

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