Management of postkidney transplant anemia – is it feasible to maintain patient and allograft survival?

Abstract

Background Kidney transplantation has been established as the best therapy for end-stage renal disease. After transplantation and to provide a prolonged and safe patient and allograft survival, early and prompt diagnosis of posttransplant sequelae, for example, posttransplant anemia (PTA) in particular, is currently crucial. Timing of presentation of this disease has its effect on PTA development. The ‘early’ presented PTA (before 6 months) may differ clinically from the ‘late’ one (after 6 months) with respect to the underlying background. Although early PTA is multifactorial, allograft dysfunction is usually the underlying mechanism in the ‘late’ one. Furthermore, PTA is currently considered as an independent risk factor for the evolution of cardiovascular system events; the latter has been proved to be the first leading cause of death in this cohort of patients. The aims and objectives of this review is to evaluate critically the risk factors responsible for PTA development, its epidemiology, diagnostic criteria, etiology for both ‘early’ and ‘late’ PTA, the available therapeutic approaches for PTA, as well as the effect of PTA in allograft and patient survival. Methods Current available literature and analysis of various trials concerned with PTA. Results The impact of anemia on patients as well as allograft outcomes cannot be simply overlooked. Management of the early as well as late PTA is crucial. However, a variety of hazards of its therapeutic options should be thoroughly considered. Conclusions A lowered threshold of post-transplant anemia (PTA) awareness and its early management has its crucial impact on allograft as well as patient survival. Benefits of PTA correction is not only reflected on patients’ and allograft longevity but also on upgrading KTRs’ quality of life.