Prevalence of iron deficiency in heart transplant recipients

Abstract

Background: Optimal iron management is crucial to marginal patients such as heart transplant recipients. As inflammatory mechanisms are present in transplant recipients, the definition of iron deficiency used in the general population might not be appropriate.

Objective: To evaluate the prevalence and determinants of iron deficiency in Norwegian heart transplant recipients.

Methods: We consecutively assessed iron parameters in all Norwegian heart transplant recipients at their annual follow-up. Several definitions of iron deficiency suggested in the literature were assessed: ferritin <100 µg/L, or ferritin 100-300 µg/L combined with transferrin saturation of <20% (ID_HF ); ferritin <100 µg/L (ID_F100 ); transferrin saturation of <20% (ID_Tsat ), and ferritin <30 µg/L (ID_F30 ).

Results: 179 of 378 heart transplant recipients (47%) had iron deficiency defined as ID_HF . 152 patients (40%) had ID_F100 , and 103 patients (27%) had ID_Tsat . 17 patients (5%) had ID_F30 . 88 patients (23%) had a C-reactive protein (CRP) >5.0 µg/L.

Conclusion: Iron deficiency defined as ID_HF , ID_F100, or ID_Tsat is prevalent in the heart transplant population, while ID_F30 is not. Further research is required to identify the mechanisms of iron homeostasis in heart transplant recipients and to establish a definition of iron deficiency suitable for this population.

Keywords: cardiac transplant recipients; exercise capacity; health-related quality of life; heart transplant recipients; heart transplantation; iron deficiency.