EFFECT OF ALUMINUM MOBILIZATION ON HEMOGLOBIN DURING THE 1ST 6 MONTHSAFTER TRANSPLANTATION

We prospectively monitored 38 patients for the first six months follow ing successful renal cadaver allograft transplantation. Hemoglobin inc reased from a mean of 8.2 +/- 0.3 g/dl to 13.4 +/- 0.3 g/dl (SEM), P < 0.001, plasma aluminum decreased from 1.3 +/- 0.2 mumol/liter to 0.46 +/- 0.04 mumol/liter, P < 0.001, and urinary aluminum excretion which peaked at one week post-transplant, 5.5 +/- 1.3 mumol/24 hr decreased to 1.8 +/- 0.3 mumol/24 hr, P < 0.001. Prior to transplantation 22 pa tients had been prescribed aluminum-containing phosphate binders. Foll owing transplantation this group had persistently greater plasma alumi num and urinary aluminum concentrations which were sustained throughou t the study period, compared with those not given aluminum containing medicaments. Hemoglobin and iron status were similar in the two groups prior to transplantation, although red blood cell volume was smaller in those given aluminum-containing phosphate binders, 89 +/- 0.9 fl (f entoliters) versus 95 +/- 1.6 fl, P < 0.05. However, the percentage in crease in hemoglobin following transplantation was greater in the grou p not given aluminum preparations, 34 +/- 4% versus 7 +/- 5% at one mo nth, 69 +/- 7% versus 37 +/- 7% at three months, and 80 +/- 8% versus 56 +/- 8% at six months respectively, all P < 0.05. This study suggest s that aluminum mobilization following successful renal transplantatio n may reduce the rate of hemopoiesis.