Impact of transfusion-associated iron overload on hepatic and renal function in patients with aplastic anemia: a retrospective cohort study of 145 cases.

OBJECTIVES

Transfusion-associated iron overload is a common complication in patients with transfusion-dependent aplastic anemia (AA). This study aimed to evaluate its impact on hepatic and renal function in AA patients.

METHODS

A total of 145 transfusion-dependent AA patients were included in this study. Baseline iron overload was evaluated using serum ferritin, and organ function was assessed via hepatic and renal biomarkers. Univariate and multivariable regression analyses were conducted to examine the associations between ferritin levels and organ dysfunction. The potential modifying effect of iron chelation therapy on these associations was also evaluated.

RESULTS

Elevated serum ferritin levels were significantly associated with increased alanine aminotransferase and lower estimated glomerular filtration rate, indicating liver and kidney dysfunction. Iron chelation therapy attenuated these associations, suggesting its protective role against iron overload-related organ dysfunction. Ferritin was independently associated with liver and kidney dysfunction, and these associations were modified by chelation exposure.

CONCLUSIONS

Transfusion-associated iron overload exerts a significant adverse effect on hepatic and renal functions in AA patients. Iron chelation therapy appears to mitigate these effects, supporting its clinical use in this patient population.