Postrenal transplant erythrocytosis: A review of 53 patients

Wickre, Curtis G.; Norman, Douglas J.; Bennison, Alice; Barry, John M.; Bennett, William M.

doi:10.1038/ki.1983.86

Cited by 129 publications

(112 citation statements)

References 19 publications

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“…Higher estimated GFR was also associated with PTE (p = 0.04), and female gender was a negative predictor of PTE (p < 0.001). When maximum serum calcium was replaced in the model by the discrete variable HC indicated by serum calcium 10.2 mg/dL, the adjusted OR for HC was 2.1 (1)(2)(3)8).…”

Section: Resultsmentioning

confidence: 99%

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Post Transplant Erythrocytosis in Hypercalcemic Renal Transplant Recipients

Kurella

Butterly

Smith

2003

American Journal of Transplantation

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In vitro data suggest that calcium plays an important role in normal and disordered erythropoiesis. The purpose of this study is to determine whether there is an association between serum calcium, various hormone levels, and the development of post transplant erythrocytosis (PTE). Data were collected on 283 patients who underwent renal transplantation between 1994 and 1998. The relationship between serum calcium and PTE development was tested using the chi-square test. Univariate and multivariable adjusted models were employed to determine predictors of maximum hematocrit. Selected patients underwent measurement of intact parathyroid hormone (PTH), 1,25-dihydroxy vitamin D, and erythropoietin (EPO). Seventy-three patients (26%) developed PTE. Post transplant erythrocytosis was more common in patients with hypercalcemia compared with patients with normal serum calcium (34% vs. 18%, p = 0.002). In multivariable analyses, serum calcium was a strong independent predictor of maximum hematocrit post transplant, even after adjustment for renal function. A serum calcium of ‡10.2 mg/dL was associated with greater than two-fold increased odds of PTE. There were no differences in hormone levels between subjects with hypercalcemia and PTE, subjects with PTE alone, and subjects with hypercalcemia alone. Hypercalcemia is associated with the development of PTE in renal transplant recipients.

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Section: Resultsmentioning

confidence: 99%

“…Post transplant erythrocytosis (PTE) is a common complication following renal transplantation, and is estimated to occur in 10-20% of renal transplant recipients (1)(2)(3). Despite recognition of this common complication, the etiology of PTE remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Post Transplant Erythrocytosis in Hypercalcemic Renal Transplant Recipients

Kurella

Butterly

Smith

2003

American Journal of Transplantation

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“…17 Long-term hemodialysis, polycystic kidney disease, graft artery stenosis, diabetes, smoking, and hypertension may contribute to the development of posttransplantation erythrocytosis. 18 In this study, 1 patient with Fabry disease also had been diagnosed with posttransplantation erythrocytosis, which might have contributed to the development of pulmonary embolism.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Objectives: Solid-organ transplant recipients can develop chronic hypercoagulation that increases the incidence of pulmonary embolism. Here, we evaluate the frequency of pulmonary embolism in solid-organ transplant recipients during the first 10 years after transplantation and evaluate the risk factors for its development. Materials and Methods:The medical records of solid-organ transplant recipients who were treated between 2003 and 2013 were retrospectively reviewed. The reviewed data included demographics, type of transplant, comorbidities, procoagulation factors, thromboembolism prophylaxis, and the timing and extent of pulmonary embolism. Results: In total, 999 solid-organ transplant recipients are included in this study (661 renal and 338 liver transplant recipients) (male: female ratio = 665:334). Twelve renal (1.2%) and 1 liver transplant recipient (0.3%) were diagnosed with pulmonary embolism. Pulmonary embolism developed 1 year after transplantation in 10 patients: 1 patient developed pulmonary embolism < 3 months after transplantation, and the other 9 patients developed pulmonary embolism within 3 to 6 months. No patients had a prior history of deep venous thrombosis or pulmonary embolism. Five patients received tacrolimus, 7 patients received sirolimus, and 1 patient received cyclosporine. Ten patients received prednisolone, and 8 patients received mycophenolate mofetil. All patients were homozygous normal for factor V Leiden and prothrombin genes. One patient was homozygous abnormal, and 1 patient had a heterozygous mutation in the methyl enetetrahydrofolate reductase gene. Two patients were treated with low-molecular-weight heparin, while the remaining patients received warfarin. Eight patients were treated for 6 months, and the remainder received longer treatments. Conclusions: Here, the incidence of pulmonary embolism in solid-organ transplant recipients is 1.2%. Renal transplant recipients are at higher risk of developing pulmonary embolism than liver transplant recipients. The factors that increase the risk of pulmonary embolism in solid-organ transplant recipients appear to be multifactorial and include genetic predisposition.

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“…5 Our patients had high blood pressure while on CYA therapy after transplant; however, they were normotensive before transplant and at the time of developing erythrocytosis. We have not documented any spontaneous remission so far.…”

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confidence: 99%

“…Reported predisposing factors in PTE are male gender and smoking, in addition to renal factors such as retention of native kidneys and transplant artery stenosis. 1,5 All our patients were men, non-smokers, not exposed to high altitude with no pre or post transplant renal, lung, hepatic or cardiac pathology. All had true erythrocytosis with an increase in the red cell mass above the normal.…”

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confidence: 99%