Erythropoietin and erythropoiesis after kidney transplantation

: In a group of 15 patients after the first transplantation of a cadaverous kidney the authors monitored for the period of one month the serum erythropoietin concentration (Epo), haemoglobin levels (Hb), the haematocrit (Ht) and serum creatinine (Cr). The objective of the investigation was to evaluate in relation to serum concentrations of Epo and the function of the graft. Erythropoietin was examined by the authors own method before and after transplantation during the first 10 days daily and then on the 12th, 15th, 20th, 25th and 30th day. Normal values are 22-44 mU/ml. The mean Epo value before transplantation was 41.9 +/- 18.8 mU/ml. After transplantation the highest mean value of Epo was recorded on the second day when it reached a value of 102.8 +/- 144 mU/ml. The mean Epo serum concentration at the end of the study was 45.9 +/- 20.9 mU/ml and did not differ significantly from values recorded before transplantation. Between Hb and Ht values and Epo serum concentrations no correlation was revealed. Conversely, statistical analysis revealed a close inverse relationship between the drop of creatininaemia and the rise of Hb and Ht values. From the results of the investigation ensues that the decisive condition for the onset of the erythropoietic response after renal transplantation is adjustment of the milieu interieur, induced by the restored excretory function of the graft which creates prerequisites for a normal response of the bone marrow to Epo.