Recombinant human erythropoietin corrects anaemia during the first weeks after renal transplantation: a randomized...

Studies on the effect of recombinant human erythropoietin (rHuEpo) on haematopoiesis in patients with kidney transplants, have been limited to progressive chronic graft failure, late after transplantation. In the present prospective randomized study, the efficacy of rHuEpo in the correction of anaemia during the first weeks after renal transplantation (RTP) was evaluated.

Patients were allocated to either an Epo- (n = 14) or a non-Epo-treated group (n = 15). Epo (150 U/kg.week s.c.) was started at a haematocrit (Hct) < 30% and was increased at weekly intervals by 30 U/kg.week, as long as Hct remained < 25%.

In the Epo group, Hct increased from a nadir of 22 +/- 4% 2 weeks after RTP to 30 +/- 4% at week 4 and to 36 +/- 4% at week 6 (P < 0.001 and P < 0.0001 respectively vs week 2). Corresponding values in the non-Epo group were 25 +/- 6%, 28 +/- 6% (P = NS) and 32 +/- 6% (P < 0.05 vs week 2) (overall evolution Epo vs non-Epo: P = 0.038 by variance analysis). The differences in Hct between the Epo and non Epo group were even more marked in patients without major complications (variance analysis P = 0.009). The Epo-treated patients required fewer post-surgical blood transfusions (0.005 vs 0.014/days follow-up, P < 0.05), in spite of greater post-surgical blood losses, especially at day 1 (P < 0.05) and the presence of more major complications (7 vs 4) and a higher number of ganciclovir-treated patients (4 vs 0; P < 0.05). The maximum Epo dose after RTP was > 2x higher than the one required before RTP (197.1 +/- 45.1 vs 85.0 +/- 76.0 U/kg.week; P < 0.05).

It is concluded that rHuEpo during the first weeks after RTP is of benefit in the correction of the Hct in the early post-surgical period, in spite of relative Epo resistance.