Erythrocytosis in renal allograft recipients. Benefit of staggered venous erythropoietin measurements

  • D. Chevet
  • Ch. Mousson
  • Y. Tanter
  • J. M. Rebibou
  • G. Rifle
  • F. Michel
  • N. Casadeval
Conference paper

Abstract

Two adult renal allograft recipients experienced erythrocytosis — one in acute form — within 3 months of grafting. Involvement of well functioning transplanted kidneys was unlikely whereas staggered erythropoietin measurements detected a high gradient in front of venous remnant kidneys. Because of these results bilateral nephrectomy was performed, which cured polycythaemia. Multiple events leading to polycythaemia after renal transplantation are reviewed and diagnosis and therapeutic schedules are proposed.

Key words

Erythrocytosis Renal transplantation Erythropoietin Erythrapheresis Bilateral nephrectomy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Aeberhard JM, Schneider PA, Vallotton MB, Kurtz A, Leski M (1990) Multiple site estimates of erythropoietin and renin in polycythemic kidney transplant patients. Transplantation 50: 613–616PubMedCrossRefGoogle Scholar
  2. 2.
    Bacon BR, Rothman SA, Ricanati ES, Rashad FA (1980) Renal artery stenosis with erythrocytosis after renal transplantation. Arch Intern Med 140:1206–1211PubMedCrossRefGoogle Scholar
  3. 3.
    Barbour GL (1979) Effect of parathyroidectomy on anemia in chronic renal failure. Arch Intern Med 139:889–891PubMedCrossRefGoogle Scholar
  4. 4.
    Barkis GL, Sauter ER, Hussey JL, Fischer JW, Gaber AO, Win-sett R (1990) Effects of theophylline or erythropoietin production in normal subjects and in patients with erythrocytosis after renal transplantation. N Engl J Med 323:86–90CrossRefGoogle Scholar
  5. 5.
    Besaras A, Caro J, Jarrell B, Burke J, Francos G, Mallon E, Karsch R (1985) Effect of cyclosporine and delayed graft function on posttransplantation erythropiesis. Transplantation 40: 624–631CrossRefGoogle Scholar
  6. 6.
    Curtis JJ (1986) Hypertension and kidney transplantation. Am J Kidney Dis 7:181–196PubMedGoogle Scholar
  7. 7.
    Dagher JF, Ramos E, Erslev AJ, Alongi SV, Karmi SA, Caro J (1979) Are the native kidneys responsible for erythrocytosis in renal allorecipients? Transplantation 28:496–98PubMedGoogle Scholar
  8. 8.
    Felle D, Tepavcevid P, Popov J, Vodopivec S, Djisalov M, Curie S, Soltes S, Mitie I, Bozi C, Hie V (1990) Erythrocytosis following renal transplantation. Xlth International Congress of Nephrology, Tokyo, 15–20 July (abstract 525 A)Google Scholar
  9. 9.
    Frassoni F, Bacigapupo A, Piaggio G, Podesta M, Marmont AM (1985) Effect of cyclosporin A on the in vitro growth of hematopoietic progenitors from normal marrow. Exp Hematol 13: 1084–1088PubMedGoogle Scholar
  10. 10.
    Garvin PJ, Reese JC, Lindsey L, Aridge DL, Domoto DT, Ballal S (1991) Bilateral nephrectomy for post-transplant erythrocytosis — Indications and results. Clin Transplant 5:313–317Google Scholar
  11. 11.
    Heilmann E, Gottschalk D, Gottschalk I, Lison AE (1983) Studies in polycythemia after kidney transplantation. Clin Nephrol 20:94–97PubMedGoogle Scholar
  12. 12.
    Lamperi S, Carozzi S, Icardi A (1984) Polycythemia is erythropoietin independent after renal transplantation? EDTA-ERA, 21:928–931Google Scholar
  13. 13.
    Meyrier A, Simon P, Boffa P, Brissot P (1981) Uremia and the liver. The liver and erythropoiesis. Nephron 29:3–6PubMedCrossRefGoogle Scholar
  14. 14.
    Nellans R, Otis P, Martin DC (1975) Polycythemia following renal transplantation. Urology 6:158PubMedCrossRefGoogle Scholar
  15. 15.
    Nies P, Colin R, Schrier SL (1965) Erythremia after renal transplantation. N Engl J Med 273:785PubMedCrossRefGoogle Scholar
  16. 16.
    Obermiller LE, Tzamaloukas AH, Avasthi PS, Halpern JA, Sterling WA (1985) Decreased plasma volume in post transplant erythrocytosis. Clin Nephrol 23:213–217PubMedGoogle Scholar
  17. 17.
    Pollack R, Maddox NS, Cohan J, Jacobson J (1988) Erythro-cythemia following renal transplantation. Influence of diuretic therapy. Clin Nephrol 29:119–122Google Scholar
  18. 18.
    Qunibi WY, AlFurayh O, Ginn HE, Barri Y, Nichols P, Duffy B, Sheth K, Taher S (1990) Post-transplant erythrocytosis. Xlth International Congress of Nephrology, Tokyo, 15–20 JulyGoogle Scholar
  19. 19.
    Schuster SJ, Wilson JH, Erslev AJ, Caro J (1987) Physiologic regulation and tissue localization of renal erythropoietin messenger RNA. Blood 70:316–318PubMedGoogle Scholar
  20. 20.
    Sun CH, Ward HJ, Paul WI, Koyle MA, Yanagawa N, Lee DBN (1989) Serum erythropoietin levels after renal transplantation. N Engl J Med 321:151–157PubMedCrossRefGoogle Scholar
  21. 21.
    Tschudi M, Landmann J, Brunner S, Thiel G (1987) Differences in the effect of azathioprine and cyclosporine on erythropoietin after renal transplantation (abstract). Kidney Int 32:431CrossRefGoogle Scholar
  22. 22.
    Webb DB, Price KA, Hutton RD, Newcombe RG, Salaman JR, Orchard J (1987) Polycythemia following renal transplantation: an association with azathioprine dosage? Am JNephrol 7:221–225CrossRefGoogle Scholar
  23. 23.
    Wickre CG, Norman DJ, Bennison A, Barry JM, Bennett WM (1983) Post renal transplant erythrocytosis: a review of 53 patients. Kidney Int 23:731–737PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • D. Chevet
    • 1
  • Ch. Mousson
    • 1
  • Y. Tanter
    • 1
  • J. M. Rebibou
    • 1
  • G. Rifle
    • 1
  • F. Michel
    • 2
  • N. Casadeval
    • 3
  1. 1.Department of Nephrology-ReanimationUniversity HospitalDijonFrance
  2. 2.Department of UrologyUniversity HospitalDijonFrance
  3. 3.Hôpital CochinParisFrance

Personalised recommendations