Post-transplant Erythrocytosis Research Articles

Post kidney transplant hematologic abnormalities and association of post-transplant anemia with graft function.

Haematological abnormalities following renal transplantation are frequently observed and have a significant effect on survival and graft outcomes. The pattern of haematological abnormalities varies globally. Few studies have been conducted in Asian countries. We aimed to evaluate the patterns of haematological abnormalities in post-transplant recipients in our center during the first year after post-renal transplant and the association of post-transplant anemia with graft function. This single-center retrospective study was conducted on renal transplantation recipients between 2014 and 2019. The study included all patients who received kidney transplants from live/cadaveric donors and had follow-up data collected up to 12 months after the transplant. The outcome studied was the prevalence of haematological abnormalities and the association between post-transplant anemia (PTA) and graft function in post-transplant recipients. A total of 106 renal transplant recipients were included in the study. The prevalence of PTA was 98% in the first week, 75% at one month, 35% at three months, 32% at six months, and 27% at 12 months. The other cytopenia cases were leukopenia (43.4%), thrombocytopenia (33.2%), and pancytopenia (15.1%). Post-transplant erythrocytosis was observed in 17.9% of patients. 18 patients with severe PTA in the first week of transplant had significant allograft dysfunction (p=0.04). Patients with and without PTA had similar graft functions at six and 12 months (p=0.50). Haematological abnormalities are common in renal transplant recipients. PTA is highly prevalent during the first week and improves over time. Other haematological abnormalities observed were leukopenia, thrombocytopenia, pancytopenia, and post-transplant erythrocytosis. Leucopenia was primarily drug-induced, and thrombocytopenia and pancytopenia were frequently caused by infections in our cohort. Additionally, severe PTA was significantly associated with graft dysfunction in the first week post-transplant, whereas similar graft function was observed at 6 and 12 months post-transplant, irrespective of the presence or absence of PTA.

Incidence, Risk Factors, and Outcomes of Posttransplant Erythrocytosis Among Simultaneous Pancreas-Kidney Transplant Recipients.

Posttransplant erythrocytosis (PTE) is a well-known complication of kidney transplantation. However, the risk and outcomes of PTE among simultaneous pancreas-kidney transplant (SPKT) recipients are poorly described. We analyzed all SPKT recipients at our center between 1998 and 2021. PTE was defined as at least 2 consecutive hematocrit levels of >51% within the first 2 y of transplant. Controls were selected at a ratio of 3:1 at the time of PTE occurrence using event density sampling. Risk factors for PTE and post-PTE graft survival were identified. Of 887 SPKT recipients, 108 (12%) developed PTE at a median of 273 d (interquartile range, 160-393) after transplantation. The incidence rate of PTE was 7.5 per 100 person-years. Multivariate analysis found pretransplant dialysis (hazard ratio [HR]: 3.15; 95% confidence interval [CI], 1.67-5.92; P < 0.001), non-White donor (HR: 2.14; 95% CI, 1.25-3.66; P = 0.01), female donor (HR: 1.50; 95% CI, 1.0-2.26; P = 0.05), and male recipient (HR: 2.33; 95% CI, 1.43-3.70; P = 0.001) to be associated with increased risk. The 108 cases of PTE were compared with 324 controls. PTE was not associated with subsequent pancreas graft failure (HR: 1.36; 95% CI, 0.51-3.68; P = 0.53) or kidney graft failure (HR: 1.16; 95% CI, 0.40-3.42; P = 0.78). PTE is a common complication among SPKT recipients, even in the modern era of immunosuppression. PTE among SPKT recipients was not associated with adverse graft outcomes, likely due to appropriate management.

Incidence, Risk Factors, and Outcomes of Post-Transplant Erythrocytosis Among Simultaneous Pancreas and Kidney Transplant Recipients

Incidence, Risk Factors, and Outcomes of Post-Transplant Erythrocytosis Among Simultaneous Pancreas and Kidney Transplant Recipients

Erythrocytosis and thrombotic events in kidney transplant recipients prescribed a sodium glucose cotransport-2 inhibitor.

The safety and efficacy of sodium glucose cotransport-2 inhibitors (SGLT2i) in kidney transplant recipients remains uncertain. Transplant recipients may be at risk of thrombosis because of post-transplant erythrocytosis and SGLT2i are associated with an increase in hematocrit. We determined SGLT2i use, the change in hematocrit and incidence of thrombotic events in kidney transplant recipients in 1700 prevalent patients in our center. Among the 42 patients treated with SGLT2i, the mean pre-transplant hematocrit was 31%, and none of the patients had a hematocrit ≥50%. The mean percent change in hematocrit measured at an average of 53 days after initiation of an SGLT2i was 11% and four patients (10%) had a hematocrit ≥ 50%. The mean hematocrit measured 3 months after treatment was 42% and two patients (5%) had a hematocrit ≥50%. One patient had a cerebellar stroke 14 months post-SGLT2i initiation when the hemoglobin was 173 grams/liter, and the hematocrit was 52%. All patients had a sustained increase in hematocrit 3 months after SGLT2i treatment. Hematocrit ≥50% occurred in 10%, and one patient had a thrombotic event that may or may not have been related to an increase in hematocrit. Clinicians may consider monitoring for erythrocytosis after starting and SGLT2i in kidney transplant recipients.

Is Erythrocytosis More Common After Simultaneous Pancreas Kidney Transplantation? A Single-Center Experience

Post-transplant erythrocytosis (PTE) is reported in 8% to 22% of kidney transplant recipients. Few studies have evaluated the prevalence of PTE in simultaneous kidney-pancreas transplantation (SPKT). This study aimed to evaluate the prevalence of PTE in a cohort of SPKT and same-donor single kidney transplant patients and find predictive factors for erythrocytosis development. A single-center retrospective cohort study was performed with 65 SPKT recipients and 65 same-donor single kidney transplant patients. Post-transplant erythrocytosis was defined as a hematocrit persistently >51% without a known cause of erythrocytosis. The PTE prevalence was 23.1% and was more frequent in SPKT patients than in single donor patients (38.5% vs 7.7%; P < .001). The mean time for PTE development was 11.2 ± 13.3 months. In the multivariate model, SPKT was the only predictor for PTE development. De novo hypertension was more frequent in the PTE group (P=.002), but there was no difference in stroke and pancreatic or kidney thrombosis occurrence. Post-transplant erythrocytosis is more common after SPKT than after single kidney transplantation. De novo hypertension was more frequent in the erythrocytosis group, but allograft thrombosis rates.

Frequency of Post-Transplant Erythrocytosis in Patients with Live Related Renal Transplant

Background: It is commonly observed in the patients undergoing kidney transplant. The red cell mass increased in this condition but the plasma volume remain normal. It is characterized by the hematocrit levels equal to 51% or greater than 51%. Study design: It was a cross-sectional and descriptive study conducted at the department of nephrology and transplantation, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences Gambat. This study was conducted for the duration of six months from January 2022 to June 2022. Material and Methods: There were total 90 patients selected for the study. There were 35 patients in the control group and 55 patients in the Post-transplant Erythrocytosis patients group. The 25 out of 35 were male and 7 were females. The 17 out of 55 were male and 38 were females. Haemoglobin and Hematocrit was assessed retrospectively. Those with Hct &gt; 51 was labelled as PTE. The study comprised of control group and PTE group having post erythrocytosis patients. The duration of dialysis of the patients was 12 and 13 months for control and PTE group respectively. Results: The red cell and plasma volume of the control group and PTE was analyzed and it showed that most of the patients had their RCV and PV in the normal range. However, there were 5 patients in control group and 15 patients in PTE group that had reported low level of RCV. The percentage of alive patients with functional graft was more in case of control (97%) as compared to PTE group (83%). Conclusion: The study was done to find the frequency of post-transplant Erythrocytosis among patients and control group. It was found that there were several risk factors that could possibly play role in causing the disease. The 21% of the patients were diagnosed with PTE. Keywords: Erthrocytosis, haematocrit, and haemoglobin.

Hematological Disorders After Renal Transplantation. A Single Center Study / Post-Kidney Transplantation Anemia and Erythrocytosis

Objective:Post-transplantation anemia (PTA) and post-transplantation erythrocytosis (PTE) are the most common hematological problems in patients after renal transplantation. Hematological disorders need to be corrected to improve the mortality and morbidity status of patients and to maintain cardiac and graft functions. The objective of this study is to determine the prevalence of PTA and PTE in kidney transplant (KT) patients in our region in our organ transplant center. Material and Methods: 212 renal transplant patients who underwent KT in a single center between 2012 and 2020 were included in the study. Demographic, clinical, and laboratory data of renal transplant patients at preoperative and postoperative months 6 and years 1, 2, 3, 4, and 5 were evaluated. Results: We determined the prevalence of PTA to be 28.16% (Early PTA 25.62%), and the prevalence of PTE to be 4.22%. The PTA group consisted of 40 patients, 33 females and 7 males, with a mean age of 30.5 years, while the PTE group consisted of only 6 male patients with a mean age of 21. Female predominance was observed in the PTA group (33, 82.5%), and male predominance (6, 100%) was observed in the PTE group. While there was no correlation between PTA and graft loss, there was a statistical correlation between PTE and graft loss (p&lt;0.001). There was no relationship between the groups in terms of mortality, tacrolimus, cyclosporin A, and erythropoietin use (p&gt;0.05). We found a negative correlation between hemoglobin levels and urea and a positive correlation between albumin, Ca, and tacrolimus levels. Conclusion: PTA is a common condition, especially in female patients, and its prevalence increases over the years if the necessary care is not taken in the follow-up, and complications that may occur can be prevented with early diagnosis and treatment. Even if the prevalence of PTE is low, especially young male patients should be followed, and treatment should be started early to prevent a possible complications.

Diagnosis and Management of Post Renal Transplant Erythrocytosis, a Case Report

A 27-year-old male was referred to the hematology polyclinic with complaints of dizziness that had been felt since the previous month. The patient had a history of end-stage renal disease and underwent a successful right kidney transplant nine months previously. Examination of the complete blood count (CBC) showed an increase in hemoglobin levels (17.88 g/dL) and hematocrit (60.14%). The patient was diagnosed with post-transplant erythrocytosis (PTE) based on persistent erythrocytosis and exclusion of other causes of erythrocytosis. Treatment with a combination of phlebotomy and ACE inhibitors can achieve the expected hemoglobin and hematocrit targets.

Prevalence and Predisposing Factors of Post Renal Transplant Erythrocytosis

Objective: Aim of current study was to determine the factors and prevalence of post-transplant erythrocytosis after kidney transplantation. Study Design: Retrospective study Place and Duration: Institute of Kidney Diseases Hayatabad Peshawar during June 2021 to December 2021. Methods: Total 118 patients of renal transplant were presented. Participants' full demographic information was recorded after getting written consent from each participant. Association of risk factors and prevalence of post-transplant erythrocytosis were recorded. Hematocrit (Ht) above 52% and haemoglobin (Hb) over 18 g/dl in males and Ht over 50% and Hb over 17 g /dl in females were considered to be indicative of true PTE. We used SPSS 18.0 to analyze all data. Results: The mean age of the patients was 50.6±2.31 years with mean BMI 27.4±11.52 kg/m2. There were majority 76 (64.4%) patients were males and 42 (35.6%) patients were females. Frequency of PTE was found in 23 (19.5%) cases and 95 (80.5%) cases were without PTE. Most common factors for PTE development were endogenous erythropoietin, local renal hypoxia, endogenous androgens, insulin-like growth factors and the renin-angiotensin- aldosterone system. Mean duration of dialysis in PTE group was 25.1±7.48 months and duration of patients without PTE was 51.9±6.75 months. Frequency of diabetes, hypertension, glomerulonephritis, polycystic kidney disease and graft failure were higher in PTE patients as compared to non-PTE. We found higher number of acute rejection in PTE patients as compared to non PTE cases with p value &lt;0.009. Conclusion: We concluded in this study that the shorter duration of dialysis and higher number of acute rejection before kidney transplant were the risk factors for post transplant erythrocytosis. Most common factor for PTE development was renin-angiotensin- aldosterone system. Keywords: Erythrocytosis, Transplantation, Kidney, Dialysis

Risk Factors for Erythrocytosis in Renal Transplantation: Is Ganciclovir Therapy One of Them?

BackgroundThe purpose of this study was to identify the prevalence and risk factors of post-transplant erythrocytosis (PTE) and its relationship with cytomegalovirus (CMV).Material/MethodsThe study consisted of patients who received a kidney allograft and followed-up in our nephrology transplantation clinic from 2000 to 2014. Patient age, sex, length of dialysis, etiology of end-stage kidney disease, date of transplantation, medications, types of donors, the development of PTE were recorded.ResultsAmong 185 adult kidney recipients, 43 (23.2%) had PTE. The average time between transplantation and diagnosis was 36 months. PTE was more common in male patients (P<0.05) and patients with living donors and those who had been treated with ganciclovir after transplantation (P<0.05). There were 79 patients treated for CMV – 54 in the non-PTE group and 24 in the PTE group. There was no significant difference in patient age, etiology of end-stage kidney disease, and immunosuppressive therapy when comparing the PTE group and non-PTE group. Univariate analysis showed ganciclovir therapy was significantly associated with PTE. However, this was not seen in the multivariate analyses.ConclusionsTreatment with ganciclovir can precipitate development of PTE. Prospective studies are needed to assess the association of between PTE and CMV infection, valganciclovir, and ganciclovir.

Risk Factors and Outcomes of Post-Transplant Erythrocytosis Among Adult Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

Risk Factors and Outcomes of Post-Transplant Erythrocytosis Among Adult Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

Risk factors and outcomes of post‐transplant erythrocytosis among adult kidney transplant recipients: a systematic review and meta‐analysis

Post-transplant erythrocytosis (PTE) can occur in up to 10-16% after kidney transplant (KT). However, the post-transplant outcomes of recipients with PTE in the literature were conflicting. We performed systematic review and meta-analysis of published studies to evaluate risk factors of PTE as well as outcomes of recipients who developed PTE compared with controls. A literature search was conducted evaluating all literature from existence through February 2, 2021, using MEDLINE and EMBASE. Data from each study were combined using the random-effects model. (PROSPERO: CRD42021230377). Thirty-nine studies from July 1982 to January 2021 were included (7,099 KT recipients). The following factors were associated with PTE development: male gender (pooled RR = 1.62 [1.38, 1.91], I2 = 39%), deceased-donor KT (pooled RR = 1.18 [1.03, 1.35], I2 = 32%), history of smoking (pooled RR = 1.36 [1.11, 1.67], I2 = 13%), underlying polycystic kidney disease (PKD) (pooled RR=1.56 [1.21, 2.01], I2 =44%), and pretransplant dialysis (pooled RR=1.6 [1.02, 2.51], I2 =46%). However, PTE was not associated with outcomes of interest, including overall mortality, death-censored graft failure, and thromboembolism. Our meta-analysis demonstrates that male gender, deceased-donor KT, history of smoking, underlying PKD, and pretransplant dialysis were significantly associated with developing PTE. However, with proper management, PTE has no impact on prognosis of KT patients.

Post-transplantation erythrocytosis in kidney transplant recipients-A retrospective cohort study.

To characterize risk factors for the development of post-transplant erythrocytosis (PTE), and its long-term effect on mortality, graft failure, and thrombosis. Retrospective study including all kidney transplant recipients in Rabin Medical Center (RMC) during the years 2005-2014. The primary outcome was a composite outcome of all-cause mortality or graft failure at the end of follow-up. Secondary outcomes included death censored graft loss, venous thromboembolism, major adverse cardiovascular events, and mortality. A matched control group was also evaluated. Univariate and multivariate time-varying Cox model analyses were conducted for outcome evaluation. A total of 1304 patients were included, 169 of whom were diagnosed with PTE (12.9%). PTE was associated with male gender, higher glomerular filtration rate (GFR), and polycystic kidney disease. PTE was found to be associated with a reduced risk of the primary outcome (HR 0.355, CI 95% 0.151-0.89, P=.027) in a univariate time-varying Cox analysis, but was not associated with the composite outcome in a multivariate analysis. There was no difference in the primary outcome when the PTE group was compared with the matched control. PTE was not found to be associated with long-term outcomes of graft failure and poor survival.

Post Allogeneic Hematopoietic Cell Transplant Erythrocytosis in Aplastic Anemia: A Review of 208 Cases

Objectives: Post transplant erythrocytosis (PTE) is a known complication of renal transplantation, however post allogeneic hematopoietic cell transplant (alloHCT) erythrocytosis was reported for the first time by us in 2011. This paper is a follow up on our initial report. Materials and Methods: Out of 253 alloHCT performed for aplastic anemia, 208 patients with 18 months post-HCT follow up were included in this analysis. PTE was defined as hemoglobin level ≥16g/dL and ≥17g/dL for females and males respectively. Patients with PTE were further investigated to rule out secondary causes. Results: Fourteen patients developed post-HCT erythrocytosis. All were male with median age of 21 years (range 16-28.5). Median disease duration prior to transplant was 7 months (range 1.5-16). Median time from HCT to development of erythrocytosis was 33 months (range 18-51). Maximum Hb level attained was 19.9 g/dL. Median erythropoietin level was 7.98mU/mL (range 2.6-13.65). None of these patients tested positive for JAK-2 V617F mutation. Four patients developed hepatitis post HCT, preceding PTE. Univariate analysis revealed significant association with male gender (OR 8.4; p=0.004), age >15 years at transplant (OR 4.2; p=0.04), pre-transplant high number of RCC (median 72 units vs 31 in non-PTE group; p<0.001) and platelets transfusions (median 249 events vs 66; p=0.001), ciclosporin-induced hypertension (OR 5.9; p=0.015) and viral hepatitis (OR 6.5; p=0.01). Except for number of platelet transfusions (p=0.015) none of the factors noted above had any significant correlation on multivariate analysis. Most patients required 2-3 phlebotomies per year. No thrombo-embolic event was observed. DisclosuresNo relevant conflicts of interest to declare.

Post-transplant erythrocytosis after kidney transplantation: A review.

Post-transplant erythrocytosis (PTE) is defined as persistently elevated hemoglobin > 17 g/dL or hematocrit levels > 51% following kidney transplantation, independent of duration. It is a relatively common complication within 8 months to 24 months post-transplantation, occurring in 8%-15% of kidney transplant recipients. Established PTE risk factors include male gender, normal hemoglobin/hematocrit pre-transplant (suggestive of robust native kidney erythropoietin production), renal artery stenosis, patients with a well-functioning graft, and dialysis before transplantation. Many factors play a role in the development of PTE, however, underlying endogenous erythropoietin secretion pre-and post-transplant is significant. Other contributory factors include the renin-angiotensin- aldosterone system, insulin-like growth factors, endogenous androgens, and local renal hypoxia. Most patients with PTE experience mild symptoms like malaise, headache, fatigue, and dizziness. While prior investigations showed an increased risk of thromboembolic events, more recent evidence tells a different story-that PTE perhaps has lessened risk of thromboembolic events or negative graft outcomes than previously thought. In the evaluation of PTE, it is important to exclude other causes of erythrocytosis including malignancy before treatment. Angiotensin converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) are the mainstays of treatment. Increased ACE-I/ARB use has likely contributed to the falling incidence of erythrocytosis. In this review article, we summarize the current literature in the field of post-transplant erythrocytosis after kidney transplantation.

Contemporary incidence and risk factors of post transplant Erythrocytosis in deceased donor kidney transplantation

BackgroundPost-Transplant erythrocytosis (PTE) has not been studied in large recent cohorts. In this study, we evaluated the incidence, risk factors, and outcome of PTE with current transplant practices using the present World Health Organization criteria to define erythrocytosis. We also tested the hypothesis that the risk of PTE is greater with higher-quality kidneys.MethodsWe utilized the Deceased Donor Study which is an ongoing, multicenter, observational study of deceased donors and their kidney recipients that were transplanted between 2010 and 2013 across 13 centers. Eryrthocytosis is defined by hemoglobin> 16.5 g/dL in men and> 16 g/dL in women. Kidney quality is measured by Kidney Donor Profile Index (KDPI).ResultsOf the 1123 recipients qualified to be in this study, PTE was observed at a median of 18 months in 75 (6.6%) recipients. Compared to recipients without PTE, those with PTE were younger [mean 48±11 vs 54±13 years, p < 0.001], more likely to have polycystic kidney disease [17% vs 6%, p < 0.001], have received kidneys from younger donors [36 ±13 vs 41±15 years], and be on RAAS inhibitors [35% vs 22%, p < 0.001]. Recipients with PTE were less likely to have received kidneys from donors with hypertension [16% vs 32%, p = 0.004], diabetes [1% vs 11%, p = 0.008], and cerebrovascular event (24% vs 36%, p = 0.036). Higher KDPI was associated with decreased PTE risk [HR 0.98 (95% CI: 0.97–0.99)]. Over 60 months of follow-up, only 17 (36%) recipients had sustained PTE. There was no association between PTE and graft failure or mortality,ConclusionsThe incidence of PTE was low in our study and PTE resolved in majority of patients. Lower KDPI increases risk of PTE. The underutilization of RAAS inhibitors in PTE patients raises the possibility of under-recognition of this phenomenon and should be explored in future studies.

Post-Transplant Erythrocytosis in Live Donor Kidney Transplant Recipients: A Retrospective Single Center Study

Introduction: Post-transplant erythrocytosis (PTE) is defined as persistently elevated hemoglobin&gt;17 g/dl and/or PCV&gt;51% in kidney transplant recipients. The incidence of PTE varies from 5% to 17%, with occasional life-threatening thromboembolic complications. We aimed to study the prevalence, risk factors and complications of PTE. Methods: We conducted a retrospective single center study in 132 kidney transplant recipients who had undergone live donor kidney transplantation at Tribhuvan University Teaching Hospital, Nepal, between October 2017 and March 2019. Prior approval was obtained from Institutional Review Committee of Institute of Medicine. Patients with hemoglobin&gt;17 g/dl were defined as PTE group, and others as non-PTE group. The pattern of hemoglobin, serum creatinine, pre-transplant hemoglobin, native kidney disease, immunosuppression medications, rejection episodes, and new onset diabetes after transplantation were analyzed and compared between two groups. Results: Out of the 132 kidney transplant recipients, PTE was diagnosed in 28 (21.2%) patients, out of which 27 patients (96.4%) were male and 1 (3.6%) were female with the mean time of onset at 7 months after transplantation. Patients with erythrocytosis had a relatively shorter duration of pre transplant dialysis (p=0.001). The mean pre transplant Hb and Hct in PTE group was 9.72g/dl and 30.35% whereas in non PTE group 10.02 g/dl and 31.31%. Thromboembolic and any other PTE related complications were not observed. Seventeen patients of PTE (60.7%) were treated with ACE Inhibitors and 11 (39.9%) patients did not require any treatment. Conclusion: Post-transplant erythrocytosis was seen in nearly one fifth kidney transplant recipients at mean time of seven months post-transplantation; was more common in male with good graft function, and short duration of pre transplant dialysis. Response to ACE inhibitors was good.

Post-Transplant Erythrocytosis in Live Donor Kidney Transplant Recipients: A Retrospective Single Center Study

Introduction Post-transplant erythrocytosis (PTE) is defined as persistently elevated hemoglobin&gt;17 g/dl and/or PCV&gt;51% in kidney transplant recipients. The incidence of PTE varies from 5% to 17%, with occasional life‑threatening thromboembolic complications. We aimed to study the prevalence, risk factors and complications of PTE.&#x0D; MethodsWe conducted a retrospective single center study in 132 kidney transplant recipients who had undergone live donor kidney transplantation at Tribhuvan University Teaching Hospital, Nepal, between October 2017 and March 2019. Prior approval was obtained from Institutional Review Committee of Institute of Medicine. Patients with hemoglobin&gt;17 g/dl were defined as PTE group, and others as non‑PTE group. The pattern of hemoglobin, serum creatinine, pre-transplant hemoglobin, native kidney disease, immunosuppression medications, rejection episodes, and new onset diabetes after transplantation were analyzed and compared between two groups.&#x0D; ResultsOut of the 132 kidney transplant recipients, PTE was diagnosed in 28 (21.2%) patients, out of which 27 patients (96.4%) were male and 1 (3.6%) were female with the mean time of onset at 7 months after transplantation. Patients with erythrocytosis had a relatively shorter duration of pre transplant dialysis (p=0.001). The mean pre transplant Hb and Hct in PTE group was 9.72g/dl and 30.35% whereas in non PTE group 10.02 g/dl and 31.31%. Thromboembolic and any other PTE related complications were not observed. Seventeen patients of PTE (60.7%) were treated with ACE Inhibitors and 11 (39.9%) patients did not require any treatment.&#x0D; ConclusionPost-transplant erythrocytosis was seen in nearly one fifth kidney transplant recipients at mean time of seven months post-transplantation; was more common in male with good graft function, and short duration of pre transplant dialysis. Response to ACE inhibitors was good.

Incidence, risk factors, and outcomes of post‐transplant erythrocytosis after kidney transplantation

The incidence, risk factors, and outcomes of kidney transplant recipients (KTRs) with post-transplant erythrocytosis (PTE) in the modern era of strong, protocolized immunosuppressive management are unknown. In this study, we aim to identify the incidence and risk factors of PTE and outcomes associated with PTE. This study examined adult KTRs transplanted at our hospital between 01/2001 and 12/2016. Controls were KTRs without PTE and selected in a 1:5 ratio using incident density sampling. Patient survival, graft survival, and vascular thromboembolism (VTE) incidence were outcomes of interest. Of 4,317 kidney transplants during the study period, 214 (5%) had PTE and were compared with controls. In the multivariate analysis, recipients with older age (HR: 0.97, 95% CI 0.96-0.99, p=.001) were less likely to develop PTE, while male gender (HR: 3.2; 95% CI: 1.92-5.3, p<.001) and non-preemptive transplant (HR: 3.86, 95% CI 1.56-9.56, p=.003) were associated with increased risk of PTE. After adjustment for confounding factors, PTE was not associated with patient mortality (HR: 0.99, 95% CI 0.69-1.42, p=.97), graft failure (HR: 1.11, 95% CI 0.68-1.80, p=.69), or VTE (HR: 1.07, 95% CI 0.59-1.96, p=.81). The incidence of PTE is still substantial in this era, but with proper management PTE does not impact patient or graft survival.

Post renal transplant polycythemia and treatment: A single center study.

To calculate the incidence of post-transplant erythrocytosis, and to assess the response to treatment. The prospective study was conducted from April 2016 to April 2018 at the Department of Nephrology, Bahria International Hospital, Lahore, Pakistan, and comprised patients undergoing renal transplantation who were evaluated and followed up for 12 months. Patients having haemoglobin levels ≥17gm/dl were labelled as having polycythemia. Data was analysed using SPSS 21. Of the 94 total patients, 69(73.4%) were enrolled. During follow-up, 2(2.9%) of them died, and, thus, the final sample stood at 67(71.3%); 57 (85%) males and 10(15%) females. The mean age of the sample was 32.6±8.8 years. Overall, 19(28.4%) patients developed polycythemia and they were either given angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Of these 19 patients, 11(57.8 %) responded to the treatment, while 8(42.1%) required phlebotomy. Further, 3(15.7%) patients required one phlebotomy, while 5(26.3%) who had glomerular filtration rate >30% had to have repeated phlebotomy. The incidence of post-transplant erythrocytosis was significantly high at 28.4%.