Impact of immediate post-transplant parenteral iron therapy on the prevalence of anemia and short-term allograft function in a cohort of pediatric and adolescent renal transplant recipients

Franca Iorember, Phoenix Children's Hospital
Diego Aviles, LSU Health Sciences Center - New Orleans
Oluwatoyin Bamgbola, SUNY Downstate Health Sciences University


Anemia is common but under-diagnosed and often inadequately treated in KTX recipients. ID is the major cause of early-onset anemia. We introduced routine use of parenteral (IV) iron in patients (2-18 years) who had KTX between January 2011 and December 2015. We explored the clinical benefits of this practice by comparing the iron-treated subjects [TX] with historical controls who had KTX between 2005 and 2010. The prevalence of anemia at 6 months (early-onset) for the cohort (both the study group and controls) was 55% and for anemia at 12 months (late-onset) was 60%. Although cause-effect relationship may not be proven in a retrospective study design, there was a significant greater frequency of ID and anemia at 3 (P <.02) and 6 months (P <.04), and a reduced allograft function (eGFR < 60 mL/min/1.73 m2) at 12 (P =.03) and 24 months (P =.04) of KTX in the control arm. Furthermore, a greater proportion of the control arm required either ESA (P =.03) or blood transfusion (P =.04) as a rescue treatment for moderate-to-severe anemia. In conclusion, routine parenteral iron treatment was associated with a lower prevalence of early- and late-onset anemia, and a lower requirement for either ESA rescue or blood transfusion.