[Post-transplantation anemia--diagnostic and therapeutic challanges]

Renal transplantation is a method of choice for treatment of patients with end-stage renal disease. Anemia may complicate post-transplantation course. It is a significant correctable risk factor for development of cardio-vascluar diseases. Based on the time of occurrence, early and late post-transplantation anemia (PTA) may be differentiated. Early PTA occurs immediately after renal transplantation. Risk factors for development of early PTA include blood loss during and after the surgery, inflammation, delayed graft function, and induction therapy with bone marrow suppression. Abrupt cessation of erythropoetin treatment may contribute to development of early PTA. The most common reason for development of late PTA is poor graft function with lack of erythropoetin or erythropoetin resistance. Etiology of PTA is commonly multifactorial and includes graft function, immunosuppressive drugs, infections and renin-angiotensin system. Treatment of anemia in renal transplant recipients demands an individual approach, with searching for the etiology of anemia. According to the current knowledge, renal transplant recipients with anemia should be treated in the same way as other patients with chronic renal failure.