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Abstract: TH-PO860

Incidence, Risk Factors, and Outcomes of Post-Transplant Erythrocytosis Among Simultaneous Pancreas and Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Gibes, Mina Lor, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Astor, Brad C., University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Odorico, Jon S., University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Mandelbrot, Didier A., University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Parajuli, Sandesh, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
Background

Post-transplant erythrocytosis (PTE) is a common condition after kidney transplantation. In the current era of immunosuppressive medication and management, the incidence, risk factors and outcomes of PTE among simultaneous pancreas and kidney (SPK) transplant recipients is poorly defined.

Methods

We analyzed all SPK transplant recipients at our center between 1998 to 2021. PTE was defined as at least 2 consecutive hematocrit (Hct) levels of > 51% within the first 2 years of transplant. Controls were selected at a ratio of 3:1 at the time of PTE occurrence using event density sampling. Risk factors for PTE and graft survival were examined.

Results

Of 887 SPK recipients, 108 (12%) developed PTE a median of 273 days (IQR: 159.5-393) after transplantation. The incidence rate of PTE was 7.5 per 100 person-years. Multivariable analysis found increased incidence associated with being on dialysis before transplant (HR: 3.15, 95% CI: 1.67-5.92, p<0.001), nonwhite donor (HR: 2.14, 95% CI: 1.25-3.66, p=0.006), female donor (HR: 1.50, 95% CI: 1.0-2.26, p=0.05), and male recipient (HR: 2.33, 95% CI: 1.43-3.70, p=0.001). The 108 cases of PTE were compared to 324 control recipients without PTE. PTE was not associated with pancreas graft failure (HR: 1.36, 95% CI: 0.51-3.68, p=0.53) or kidney graft failure (HR: 1.16, 95% CI: 0.40-3.42, p=0.78).

Conclusion

In the modern era of immunosuppression, PTE is still a common complication among SPK recipients. Likely due to proper management, PTE among SPK recipients was not associated with adverse graft outcomes.