Effect of renal transplantation on haematological profile of patients with end-stage renal disease

Objective: Abnormalities in haematological values in end-stage renal disease (ESRD) patients and their correction after successful kidney transplantation were investigated. Subjects: A group of 41 patients were studied before and up to 1 year after transplantation. Values were compared with those obtained in 34 matched healthy volunteers. Results: ESRD patients had significantly lower mean haemoglobin (Hb), haematocrit (Hct), and red blood cells (RBC) values (7.6 +/- 1.3 g/dl; 0.25 +/- 0.13 l/l and 2.8 +/- 0.5 x 10(12)/1 respectively) than healthy volunteers (14.1 +/- 1.9 g/dl, 0.45 +/- 0.06 l/l and 5.1 +/- 0.7 x 10(12)/1, respectively). They also had slightly lower mean platelet, lymphocyte and monocyte counts. All other haematological parameters measured were normal. Correction of anaemia after renal transplantation began promptly, but progressed slowly. Only 21.9% of all patients achieved a normal range of Hb by the end of 3 months and 53.7% at the end of 1 year. Early graft rejection adversely affected early recovery of Hb values. At all time points post-transplant, mean Hb values were significantly higher (p<0.05-p<0.001) in recipients of kidneys from living related donors than in recipients of cadaveric kidneys (e.g. 13.3 +/- 1.0 g/dl vs 9.8 +/- 0.7 g/dl after 6 months). Female patients tended to recover their normal Hb values faster than males. No role for the immunosuppressor cyclosporin-A in the rate of resolution of anaemia was found. Conclusion: The results show that anaemia associated with chronic renal failure persists in about half of all patients 1 year after successful kidney transplantation. Its resolution is better in recipients of kidneys from living donors, but hampered by graft rejection.