Relative decrease in hemoglobin and outcomes in patients undergoing kidney transplantation surgery: A retrospective cohort study - 16/09/21
, Agnihotram V. Ramanakumar b , Chee Saw b, c , Veronique Naessens c , Nasim Saberi d , Marcelo Cantarovich e , Dana Baran e , Steven Paraskevas d , Jean Tchervenkov d , Prosanto Chaudhury d , Shaifali Sandal b, e, ⁎ Abstract |
Background |
Recent surgical literature suggests that a relative decrease in hemoglobin (ΔHb) is predictive of adverse outcomes regardless of the absolute level. We aimed to examine the association between perioperative ΔHb and kidney transplantation (KT) outcomes.
Methods |
This was a retrospective cohort study of transplant recipients, where ΔHb = 
(Hb0 = hemoglobin pre-KT and Hb1 = lowest hemoglobin 24-h post-KT). The main outcome of interest was immediate graft function (IGF).
Results |
Of the 899 eligible patients, 38% experienced IGF, and ΔHb was associated with 36% lower odds of IGF. Also, ΔHb was associated with higher all-cause graft failure and longer length of stay but not death-censored graft failure or mortality. ΔHb ≥30% was the threshold beyond which the odds of IGF were significantly lower even if Hb1 was ≥7 g/dL.
Conclusion |
ΔHb is associated with inferior outcomes independent of Hb1; whether it can be used to guide transfusion practices should be explored.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | During kidney transplantation, the impact of perioperative changes in hemoglobin is unknown. |
• | Relative change in recipient hemoglobin is associated with inferior transplant outcomes. |
• | Hemoglobin decline of ≥30% is identified as the threshold for this. |
• | This remains significant even when the lowest perioperative hemoglobin was ≥7 g/dL. |
• | Relative change in hemoglobin should be explored to guide transfusion practices. |
Keywords : Kidney transplantation, Anemia, Hemoglobin, Transplant outcomes, Blood transfusion
Plan
Vol 222 - N° 4
P. 825-831 - octobre 2021 Retour au numéro
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