Heart Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Heart Transplant, including details on risks, prognosis, procedure, surgery, organ donation.

The effects of pre- and post-transplant anemia on 1-year survival after cardiac transplantation.

Taegtmeyer AB, Rogers P, Breen JB, Barton PJ, Banner NR, Yacoub MH

Transplant Unit, Harefield Hospital, Harefield, Middlesex, United Kingdom.

BACKGROUND: Anemia is associated with a poor prognosis in heart failure. Recent studies have also suggested that anemia may be a predictor of survival after heart transplantation. METHODS: We investigated whether anemia before or after orthotopic cardiac transplantation affected post-transplant survival and analyzed data from a historical cohort of 267 consecutive adult patients who underwent transplantation between 1994 and 1999. Hemoglobin levels immediately before and at 6 weeks after orthotopic cardiac transplantation were recorded. Anemia was defined as a hemoglobin level less than 12 g/dl. The outcome was all-cause mortality. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards models. RESULTS: Pre-transplant anemia was present in 26% (n= 70). One-year survival was 70% in subjects who were anemic before transplantation compared with 81% in those who were not (p = 0.03). Multivariate analysis showed a 1-year mortality hazard ratio for pre-transplant anemic subjects of 1.77 (95% confidence interval, 1.03 3.0, p = 0.038). Anemia was more prevalent after transplantation (78%). There was no difference in 1-year survival between post-transplant anemic and non-anemic subjects. CONCLUSION: Anemia before, but not after transplantation, is a common independent predictor of 1-year survival in cardiac transplant patients.

Published 31 March 2008 in J Heart Lung Transplant, 27(4): 394-9.
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