RECOMBINANT ERYTHROPOIETIN TREATMENT FOR SEVERE ANEMIA IN PREGNANT KIDNEY TRANSPLANT RECIPIENTS

Objective. To develop a treatment with recombinant erythropoietin (rEPO) for severe anemia in pregnant kidney transplant women receiving iron-containing agents. Subjects and methods. Sixty-eight pregnant kidney transplant patients were followed up; of whom 19 (27.9%) women were found to have anemia with a hemoglobin (Hb) level of 490 g/l. The women’s mean age was 25.9±3.8 years. Primiparas and multiparas constituted 21 and 79%, respectively. Administration of rEPO was started at an Hb of 490 g/l with a dose of 2000 IU subcutaneously thrice weekly in the use of parenteral iron preparations (iron saccharate). After Hb increased by at least 5 g/l, maintenance therapy with rEPO was continued in a subcutaneous dose of 2000 IU once weekly in the oral use of iron preparations in a therapeutic dose (one tablet twice daily). Results. Gestational age at the start of therapy was 26.8±.3.5 weeks; the mean Hb concentration was 86.14±4.9 g/l; red blood cells, 2.86±0.28x10 12/l. The duration of rEPO therapy did not exceed 2 weeks; that of maintenance therapy ranged from 4 to 8 weeks. At delivery, the mean Hb concentration reached 104±3.14 g/l; red blood cells were 3.42±0.1x10 12/l. The gestational age at delivery was 35.2±1.2 weeks; the birth weight was 2543±244 g and the height was 45.8±3.5 cm. All the patients were delivered via caesarean section. The postoperative bed days averaged 11 days. No postpartum infectious and inflammatory diseases were observed. Conclusion. Treatment with rEPO for anemia in pregnant kidney transplant recipients can substantially improve therapeutic effectiveness for its severe forms, decrease inpatient treatment time, improve fetoplacental unit function, and reduce the frequency of postoperative infectious complications.

pregnant women, anemia, grafted kidney, erythropoietin