Case 2: 36-year old female renal transplant recipient
Post-transplant anaemia is associated with higher rejection rates and worse graft survival, compared with non-anaemic renal transplant recipients.(1) Therefore, identifying all causes of anaemia, including iron deficiency, is essential to improve the long-term success of transplantation. However, determining the underlying cause of anaemia can be complicated owing to the co-morbidities and co-medications associated with transplantation.(2)
This interactive case study was developed with the expertise and support of Professor Simon Roger (Director of Renal Medicine and Professor of Clinical Medicine, University of Newcastle, Australia), and enables you to apply the new knowledge you have gained in a practical way that will help you to improve the outcomes of your patients.
In this case, a 36-year old woman who has undergone a living-related donor kidney transplant and being treated with immunosuppressive drugs is complaining of tiredness, tremors, tingling and impaired memory. What would be your initial assessment of the situation – would you stop or change the immunosuppressant drug regimen? These questions and more can be explored in this complex and challenging case study. Key learning points throughout the case study will offer explanations regarding the correct strategy.
- Chhabra D, Grafals M, Skaro AI, et al. Impact of anemia after renal transplantation on patient and graft survival and on rate of acute rejection. Clin J Am Soc Nephrol 2008;3:1168–1174.
- Winkelmayer WC, Chandraker A. Pottransplantation anemia: management and rationale. Clin J Am Soc Nephrol 2008;3 Suppl 2:S49–55.