Correction of iron deficiency anemia in liver transplantation. Preliminary study.

CONTEXT: In liver transplantation (LT), anemia and transfusion of blood products have a negative impact on morbidity and mortality.

METHODS

Multicenter, prospective observational study. The main objective was to assess whether correction of iron deficiency anemia with intravenous iron was feasible in LT candidates. Its efficacy and adverse effects were evaluated. Patients with Hb value <115g/l and ferritin values <800ng/ml were included. Based on the increase in Hb>10g/l compared to its baseline level, the analysis of 76 patients was considered. An anemia study was carried out, assigning to the study group those who met the criteria for iron deficiency anemia, which followed a protocol of administration of up to two doses of iron before LT.

RESULTS

Two hundred ninety-six LT were performed during the study period, 48% of patients had an Hb value <115g/l. Forty-three patients made up the study group, in 5 patients the first dose was not administered. The second dose was administered to 55% of patients. No patient presented serious adverse effects or alterations in liver function. Hemoglobin increased compared to baseline by a median of 11.22g/l (6.47-15.97) after the first administration and 11.64g/l (6.49-16.78) after the second.

CONCLUSIONS

The implementation of patient blood management in LT through the administration of intravenous iron is effective and safe. It is necessary to routinely characterize and treat the presence of iron deficiency anemia in these patients.