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Open Access 01-12-2021 | Anemia | Research article

Blood volume and hemoglobin mass in long-term heart transplant recipients with and without Anemia

Authors: Florian Seiler, Christoph Ahlgrim, Philipp Birkner, Nina Wrobel, Jonathan Rilinger, Sebastian Grundmann, Christoph Bode, Torben Pottgiesser

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

In systolic chronic heart failure, a heterogeneous blood volume (BV) regulation can be found with plasma volume expansion in many cases, possibly leading to pseudoanemia. Little is known about the volume status after heart transplantation (HTX). So far, anemia of HTX recipients was solely investigated using hemoglobin-concentration that may be misleading in a clinical context. The objective of the study was whether a difference in plasma volume and red cell volume can be observed in clinically stable heart transplant recipients compared to matched control subjects. Secondary, the aim was to describe anemia in the long-term after HTX based on quantitative data.

Methods

Blood volume and its constituents red cell volume and plasma volume were quantified using an abbreviated carbon monoxide rebreathing method (aCORM) with focus on its primary measure total hemoglobin mass (Hbmass) and coincidental anemia in 36 (7 women) heart transplant recipients. For comparison, a matched control group of 46 (5 women) healthy subjects was selected.

Results

Neither Hbmass nor blood volumes were significantly different in HTX patients compared to matched healthy control group subjects. The prevalence of anemia 6.3 ± 4.3 years after transplantation was 19%. Hbmass and red cell volume were significantly lower in anemic HTX patients compared to non-anemic patients while plasma volume was not expanded. Various immunosuppressant regimens did not have an effect on Hbmass, plasma volume or red cell volume.

Conclusions

There was no difference in blood volumes and Hbmass between HTX patients and control subjects. The pathophysiologic blood volume regulation in chronic heart failure does not seem to be longer active in long-term HTX recipients. However, in the long-term after HTX, anemia occurs in a considerable number of patients as true anemia without a clear association with immunosuppression.

Trial registration

German registry for clinical studies, DRKS00006078. Registered 09 May 2014, https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID=DRKS00006078.

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Title: Blood volume and hemoglobin mass in long-term heart transplant recipients with and without Anemia
Authors: Florian Seiler
Christoph Ahlgrim
Philipp Birkner
Nina Wrobel
Jonathan Rilinger
Sebastian Grundmann
Christoph Bode
Torben Pottgiesser
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Anemia
Heart Transplantation
Heart Transplantation
Heart Transplantation
Heart Transplantation
Heart Transplantation
Chronic Heart Failure
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01510-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Blood volume and hemoglobin mass in long-term heart transplant recipients with and without Anemia

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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