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Table 3 Kidney transplant studies

From: Erythropoiesis stimulating agents and reno-protection: a meta-analysis

Reference Study Location ESA Control Subjects (Total and # in groups) DGF definition Other Outcomes
Aydin 2012 [31] Netherlands (Leiden University Medical Center) Epoetin β (33,000 IU) on 3 consecutive d, starting 3–4 h before transplantation & 24 & 48 h post-reperfusion. Saline solution (0.9%) N = 92: ESA(45), control(47) Need for dialysis in the first wk or if sCr increased, remained unchanged or decreased by less than 10% per d during 3 consecutive d for more than 1 week No significant differences in Hb, endogenous creatinine clearance or proteinuria
Coupes 2015 [30] United Kingdom (Manchester Royal Infirmary) Epoetin β (100,000 U; 33,000 intraoperative and 33,000 at 24 and 48 h). Placebo (not disclosed) N = 39: ESA(19), control (20) Need for dialysis in first 7 days post-transplant No difference in Hb or number of transfusions. No significant difference in sCr or eGFR at any time point to 90 day, No difference in acute rejection episodes, or biomarkers (NGAL, KIM-1 or IL-18)
Hafer 2012 [32] Germany (Hannover Medical School) Epoetin α (40,000 U (iv); Eprex) immediately before reperfusion and d3 and d7 after transplantation Placebo (not disclosed) same volume and appearance N = 88: ESA (44), control (44) Urine output of less than 500 ml in the first 24 h after transplantation and/or need of dialysis because of graft dysfunction within the first wk after transplantation Higher Hb at 2 and 4 but not 6 weeks. No significant difference in transfusions, eGFR 6 weeks or 12 months. No significant differences 6 weeks and 6 months post-transplant in histological indices.
Kamar 2010 [23] France (Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse) Epoetin α or epoetin β (250 IU/kg/week) on d5 post-transplant, unless Hb level was above 12 g/dl for women and 13 g/dl for men. Cumulative ESA dose (D30) was 727 ± 499 IU/kg. No ESA during the first month post-transplantation unless Hb dropped to <8 g/dl) N = 181: ESA (82), control (99) NA Reduced Hb in ESA arm. No difference in transfusions. sCr levels were similar in both groups at 3, 6 and 12 months post-transplantation
Martinez, 2010 [33] France (13 centers) Epoetin β (30.000 IU; Neorecormon) given before surgery and at 12 h, d7 and d14 No ESA during the first month post transplantation N = 104: ESA (51), control (53) The need for dialysis during the first wk after transplantation Higher Hb in ESA arm at 1 month. No difference in transfusions. No difference in sCr at any time point. No difference in eGFR at 1 or 3 months
Sureshkumar 2012 [34] Pennsylvania (USA) (Allegheny General Hospital, Pittsburgh, Pennsylvania) Epoetin α (100,000 U (iv); Procrit) intraarterially immediately after reperfusion Matched placebo (not disclosed) N = 72: ESA (36), control (36) The need for dialysis within the first wk of transplantation No difference in Hb, sCr, eGFR or urinary biomarkers of AKI (NGAL or IL-18)
Van Biesen 2005 [35] Belgium (University Hospital Ghent) Epoetin β (100/IU/kg; Recormon) immediately after transplantation then thrice weekly to maintain Hb above 12 g/dL No ESA N = 26: ESA (14), control (12) Not defined Shorter time to target Hb in ESA arm. No difference in transfusions or sCr at 3 months
Van Loo 1996 [36] Belgium (University Hospital, Gent, Belgium) Epoetin β (within 1 week post transplant). Starting dose was 150 U/kg 3X/week (sc), for a maximum of 12 weeks to maintain Hct between 25% and 35%. No ESA N = 29, ESA (14), control (15) T1/2 sCr (the time for sCr to reach 50% of the pre-transplantation value for more than 2.5 days) Increased Hb and reduced transfusions in ESA arm. No difference in sCr at any time point.