Negative effects of anemia on quality of life and its improvement by complete correction of anemia by administration of recombinant human erythropoietin in posttransplant patients

Background

Anemia is a common complication in posttransplant patients (posttransplant anemia: PTA). We tested the hypothesis that targeting hemoglobin (Hb) over 13.3 g/dl by administration of recombinant human erythropoietin (rHuEPO-ad) has positive impact on quality of life (QOL).

Methods

Twenty-four patients, whose initial Hb and estimated glomerular filtration rate (eGFR) were 10.5 ± 0.2 g/dl and 48.5 ± 2.7 ml/(min 1.73 m²), respectively, were enrolled in the present study. Physical and mental QOL in these patients before and after rHuEPO-ad were acquired and summarized as physical summary sore (PSC) and mental summary sore (MSC), respectively, by the 36-item Short Form (SF-36), an international questionnaire for analysis of QOL.

Results

Before rHuEPO-ad, posttransplant patients had preserved MSC (54.1 ± 2.3) but impaired PSC (32.6 ± 3.2). rHuEPO-ad for 6 months increased their Hb to 13.7 ± 0.3 g/dl. This was accompanied by improvement of PSC (49.1 ± 2.1: P < 0.01 versus before rHuEPO-ad). MSC was preserved during rHuEPO-ad (54.4 ± 1.6: NS versus before rHuEPO-ad). There was inverse correlation between initial PSC or MSC and responses of these parameters to rHuEPO-ad (PSC, P = 0.007; MSC, P = 0.009). Patients whose initial PSC was lower than 39.6 or whose initial MSC was lower than 39.4 were expected to improve their PSC or MSC by more than 10 by rHuEPO-ad.

Conclusions

Anemia in posttransplant patients has negative impacts on their QOL. Scoring mental and physical QOL by SF-36 in posttransplant patients is useful to identify groups of patients whose QOL could be improved by rHuEPO-ad.