Post-Liver Transplantation Anemia and Its Correlation with Mortality and Graft Failure
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ORIGINAL ARTICLE
Post‑Liver Transplantation Anemia and Its Correlation with Mortality and Graft Failure Tamar Berger1,2 · Iddo Reisler2 · Tzippy Shochat3 · Pia Raanani1,2 · Eviatar Nesher2,4 · Eytan Mor2,4 · Anat Gafter‑Gvili1,2,5 · Amir Shlomai2,6 Received: 11 August 2019 / Accepted: 18 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Post-transplantation outcomes · Liver diseases · Blood tests · Prognosis · Markers
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10620-019-06021-7) contains supplementary material, which is available to authorized users. * Amir Shlomai [email protected] 1
Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah‑Tikva, Israel
2
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3
Bio‑Statistical Unit, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
4
Department of Transplantation, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
5
Department of Medicine A, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
6
Department of Medicine D and the Liver Institute, Rabin Medical Center, Beilinson Hospital, Beilinson Campus, 39 Jabotinsky Street, Petah Tikva, Israel
Patients with chronic liver disease and hepatic cirrhosis develop abnormal hematologic indices due to diverse etiologies, most commonly hypersplenism [1]. Among these abnormal hematologic indices, anemia is frequent, occurring in approximately 75% of patients with chronic liver disease [2]. However, after liver transplantation there is a reversal of many pathological processes that directly o
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