ackground : In chronic renal failure, anemia develops due to uremic inhibitor, hemolysis
and blood loss but mainly due to relative deficiency of Erythropoietin (EPO) compared to the
level of anemia. Many studies about the changes of EPO after renal allograft have been
done on the cadaveric-donor kidney recipient by other investigators but few studies were
reported on living-donor renal allograft so far. We studied the changes of EPO and
hemoglobin after living-donor kidney allograft with less ischemic time than cadavericdonor
renal allograft.
Method : We studied prospectively the serial changes of BUN, serum creatinine,
hemoglobin, hematocrit, reticulocyte count, serum EPO level, serum iron and TIBC with
regular intervals from preop. 7th day to postop. 28th day on the 19 patients who had done
livingdonor renal allograft at Severance hospital from 18th Dec., 1991 to 20th Mar., 1992.
Result :
1) As renal function became to normal after renal allogrft, serum EPO concentration
increased significantly from 12.3±20.6 U/L on the preop. 1st day to 24.2±20.6 U/L on the
postop 1st day and 25.2±16.6 U/L on the postop. 3rd day (p<0.05).
2) The peak serum EPO concentration was noted between postop. 1st day and 3rd day,
and thereafter serum EPO concentration decreased slightly but maintained to be higher than
preop. Level significantly (p<0.05).
3) Reticulocyte count increased significantly from preop. 0.5±0.3% to postop. 5th day, 1.7±
1.1% (p<0.05) which was 4 days later than the peak of EPO.
4) Platelet, serum iron, TIBC, and serum ferritin levels were not changed after renal
transplantation.
Conclustion : Although serum EPO concentration did not show the late peak which was
usually reported in cadaveric-donor renal transplantation, we noted the serum EPO level
maintained to be significantly high level with early peak after living-donor renal
transplantation. But reticulocyte count increased significantly 4 days later than the peak of
serum EPO level suggesting that the initial peak of EPO level came from renal ischemia
during renal transplantation and the persisting high but slightly downed EPO level was from
wellfunctioning renal allograft.
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