[Post transplant erythrocytosis and the effect of treatment with enalapril]

ABSTRACT

Post transplant erythrocytosis [PTE], defined as a hematocrit level of above 51 percent, is a multifactorial condition common in renal transplant recipients. Traditional therapies include repeated phlebotomies, bilateral native nephrectomies, and anticoagulant therapy. The aim of this study was to evaluate the efficacy of ACE inhibitor on PTE. This analytic outcome study was done on all transplant patients referred to Shaid Rahnemoon hospital [Yazd, Iran]. Hematocrit [HCT] and hemoglobin were assessed in two blood samples taking from the patients. Patients with HCT >51 were selected and studied for other causes of polycythemia. Not finding other causes, the patients were diagnosed as PTE and received Enalapril tab [5 mg /daily]. Blood pressure, HCT and Hb of these patients were recorded during next 3 months [30, 60, 90th post-treatment days]. Among 126 referred patients, 47 patients had erythrocytosis [37 males [86%] and 6 females [14%]] that shows a higher prevalence in comparison with other studies. All patients responded to Enalapril treatment. Before treatment, mean hemoglobin and hematocrit were 18.35 +/- 0.59 gr/l and 55.96 +/- 1.90mm respectively, while after 3 months treatment with Enalapril, hemoglobin and hematocrit decreased to 16.7 +/- 0.5 mg/l and 48.73 +/- 1.42 mm respectively. Enalapril is an effective treatment of PTE and can prevent the need for phlebotomy or nephrectomy in these patients