Prevalence of iron deficiency in heart transplant recipients

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 mu g/L, or ferritin 100-300 mu g/L combined with transferrin saturation of <20% (IDHF); ferritin <100 mu g/L (IDF100); transferrin saturation of <20% (IDTsat), and ferritin <30 mu g/L (IDF30). Results 179 of 378 heart transplant recipients (47%) had iron deficiency defined as IDHF. 152 patients (40%) had IDF100, and 103 patients (27%) had IDTsat. 17 patients (5%) had IDF30. 88 patients (23%) had a C-reactive protein (CRP) >5.0 mu g/L. Conclusion Iron deficiency defined as IDHF, IDF100, or IDTsat is prevalent in the heart transplant population, while IDF30 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.