Background:
@EN Following successful kidney transplantation, renal anemia is corrected during the first 3~4 months and serum ferritin (SF0 levels decreased markedly during the first 3 months posttransplant. However, renal transplant recipients (RTR0 with
severe
iron overload had a gradual decrease of SF levels after transplantation. It is suggest that evolution of SF levels after transplantation is mainly determined by previous state of iron storage.
@ES Methods:
@EN twenty-four patients (16 males, 8 females, mean age 35.6±2.2 years0 underwent renal transplantation between February 1989 and September 1992. All patients were living donor kiidney recipients with high basal SF levels (<350 ng/ml). Group I
(N-12,
SF: 350~800 ng/ml) had above normal basal SF levels anf Group II (N-12, SF: <800 ng/ml) had a high basal SF levels. SF levels quantified with microparticled enzyme mjmunoassay technique in all patients at pretransplant, 1, 6, 9 and 12 months
after
transplantation five patients in group II were intermittent phlebotomized 3 months after transplantation. Magnetic resonance (MR0 images of 6 patients were obtained using a 2.0 tesla spectro 20.000.
@ES Results:
@EN Mean Hb Levels increased in 24 RTR from 7.3±0.2 g/dl before transplantation to 13.3±0.3 g/dl 3 months after transplantation. The mean SF level of Group I showed a rapid decreased from 572±37 ng/ml before transplantation to 195±60 ng/ml at
3
months after transplantation. In Group II, the mean SF level decreased graduall from 1,806±389 ng/ml before transplantation to 1,084±387 ng/ml, 774±147 ng/ml, at 5 months and 12 months osttransplant. At the 24 months posttransplant, mean SF
level was
616±99 ng/ml. Five patients of Group II who underwent intermittent phlebotomy, SF level decreased from 2,384±641 ng/ml before transplantation to 1,094±278 ng/ml at 12 months posttransplant. MR imaging of 6 patients in Group II (basal SF:
<1,000
ng/ml) was evaluated. Signal intensity of liver ws relatively lower than paraspinal muscles and nearly equal to background noise.
@ES Conclusion:
@EN RTR with high basal SF or hemochromatosis should receive more intensive form of therapy including intermittent phlebotomies for prevent progress to subsequent liver dysfunction. SF level be monitored with regular intervals because of their
persistent high ferritin levels after transplantation. Also, MR imaging serve as a noninvasive diagnostic tool and guidance for therapeutic decisions.
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