Erythropoiese und Serumerythropoietinkonzentration vor und nach Nierenallotransplantation

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Abstract
Hematological parameters and serum erythropoietin (EPO) levels were measured before and sequentially after grafting in 50 consecutive cadaver renal transplant recipients. EPO was estimated using a sensitive radioimmunoassay. Values for nonanemic controls were 15-25 mU/ml. Mean hematological values before transplantation were as follows: hemoglobin 9.7 .+-. 2.4 g/dl, hematocrit 29 .+-. 8%; corrected reticulocytes count 15 .+-. 8.permill. and EPO 29 .+-. 23 (11-131) mU/ml. In the entire studied population, 35 patients had inadequate low EPO levels for their degree of anemia. In the whole population, there was a significant positive exponential correlation between EPO and hematocrit (r = 0.31; p < 0.05). In the subset of patients with underlying cystic kidney disease and in hemodialysis patients treated with recombinant human EPO, hemoglobin, hematocrit and EPO levels were higher when compared to hemodialysis or CAPD patients with other kidney diseases. Following successful renal transplantation, EPO increased to 45 .+-. 31 mU/ml at 1 month and then decreased to 25 .+-. 18, 18 .+-. 7 and 19 .+-. 4 mU/ml at 3, 6 and 9 months, respectively. Within the 1st month after transplantation there was a 4-fold increase in reticulocytes from 9 .+-. 5 to 38 .+-. 14.permill., followed by a slow decrease over the next several months to 23 .+-. 11.permill. at 9 months. In contrast, the hematocrit level rose more gradually from 28 .+-. 7 to 44 .+-. 6% at 9 months. In 25 of 36 patients with a functioning graft who were followed for more than 6 months, anemia was corrected and 11 patients remained slightly anemic with a mean hematocrit level of 36 .+-. 4%. EPO levels were comparable in both subgroups of patients: 28 .+-. 22 and 26 .+-. 19 mU/ml, respectively.