HIGH PREVALENCE OF ANEMIA AFTER CARDIAC TRANSPLANTATION IN CHILDREN

Background. Chronic anemia is common in adults after successful cardia c transplantation. However, the prevalence of anemia in children after cardiac transplantation is uncertain, The purpose of this study was t o investigate the prevalence and causes of chronic anemia in well chil dren after cardiac transplantation and in particular to define the rol e, if any, of iron deficiency, which is important and relatively commo n in normal children. Methods, Twenty children (ages 7 months to 16 ye ars) who were well 4 months to 6 years after cardiac transplantation w ere studied, Fourteen children (70%) were anemic and enrolled in a pro spective trial of iron supplementation. Results, In the majority of ch ildren, serum iron and erythropoietin levels were low, although serum ferritin and zinc protoporphyrin levels tended to be normal or high, O nly one child demonstrated a definite response to iron supplementation , although the hemoglobin level remained low. Conclusions. Anemia is h ighly prevalent in this population, and, despite the presence of low s erum iron and transferrin saturation, anemia is not usually due to iro n deficiency, Although the diagnosis of iron deficiency in this group is difficult and must not be missed, inappropriate therapy should be a voided, In the majority of children, there appears to be an anemia of chronic disease which may be secondary to chronic inflammation or an e ffect of cyclosporine on erythropoietin production.