Volume 18, Issue 2 pp. 148-156
Original Article

Haemoglobin variability in the early post-transplant period: Association with graft survival and mortality

Benaya Rozen-Zvi

Corresponding Author

Benaya Rozen-Zvi

Nephrology and Hypertension, Rabin Medical Center, Petah Tikva

Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv

Conflict of interest: all authors – none declared.

Correspondence:

Dr Benaya Rozen-Zvi, Department of Nephrology and Hypertension, Rabin Medical Center, Petah Tikva, Israel. Email: [email protected]

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Binjamin Ben-Avraham

Binjamin Ben-Avraham

Cardiology, Rabin Medical Center, Petah Tikva

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Shira Schneider

Shira Schneider

Internal Medicine D, Rabin Medical Center, Petah Tikva

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Anat Gafter-Gvili

Anat Gafter-Gvili

Internal Medicine E, Rabin Medical Center, Petah Tikva

Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv

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Rachel S Levy-Drummer

Rachel S Levy-Drummer

Everard and Mina Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel

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Boris Zingerman

Boris Zingerman

Nephrology and Hypertension, Rabin Medical Center, Petah Tikva

Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv

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Eitan Mor

Eitan Mor

Organ Transplantation Department, Rabin Medical Center, Petah Tikva

Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv

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Uzi Gafter

Uzi Gafter

Nephrology and Hypertension, Rabin Medical Center, Petah Tikva

Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv

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Ruth Rahamimov

Ruth Rahamimov

Nephrology and Hypertension, Rabin Medical Center, Petah Tikva

Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv

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First published: 07 November 2012
Citations: 1
Equal contribution.

Abstract

Aim

Haemoglobin (Hb) variability is associated with poor survival in patients with chronic kidney disease. Association of Hb variability after kidney transplantation with patients' and graft survival has not been adequetly studied.

Methods

This retrospective study used registry data to examine the association between Hb variability in the early post-transplant period (first 6 months) and graft survival after kidney transplantatin. Kaplan–Meier and Cox regression analyses were used for univariate and multivariate associations between mortality, death censored graft survival and the composite outcome of both, in 752 patients after kidney transplantation. Hb values were collected each month during the first 6 months after transplantation, and Hb variavility was calculated using the residual standard deviation method.

Results

The highest quartile of Hb variability was associated with inferior graft and patients' survival in univariate (hazard ratio (HR) 2.18; 95% confidence interval (CI) 1.51 to 3.13; P < 0.001) and multivariate models (HR 1.5; 95% CI 1.029 to 2.18; P = 0.035). This association was mainly due to increased death censored graft failure in the high variability group (HR 2.75; 95% CI 1.73 to 4.38; P < 0.001) and (HR 1.67; 95% CI 1.023 to 2.74; P = 0.04) in the univariate and multivariate models, respectively. There was no association between Hb variability and the risk of death (HR 1.51; 95% CI 0.88 to 2.57; P = 0.132).

Conclusion

High Hb variability is independently associated with inferior graft survival in patients after kidney transplantation.

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