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ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Nephrology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1452928
Left heart function and strain in predicting change in hemoglobin levels in pediatric kidney transplantation recipients
Provisionally accepted
Shufan Yue 
Fei Xiao Rui Fan 
Wei Li 
Donghong Liu 
Fengjuan Yao Hong Lin 
Chenglin Wu 
Longshan Liu 
Changxi Wang 
Jun Li *
Cuiling Li *- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Introduction: Anemia is prevalent after kidney transplantation (KTx) and is associated with reduced graft survival. The associations between temporal changes in hemoglobin (Hb) level at the early posttransplant period with left ventricular (LV) and atrial (LA) function and strain are unknown.The study cohort included 71 successful pediatric KTx recipients between January 2021 and September 2022. Echocardiography was used to evaluate the cardiac structure, function, and strain both before and after KTx. Temporal changes in Hb values within 6 months after KTx were evaluated. According to the LV mass index (LVMI), recipients were divided into the left ventricular hypertrophy (LVH) group and the non-LVH group.Results: Before KTx, the LVH group had a lower level of Hb and a higher incidence of anemia than the non-LVH group. However, this difference between the groups had disappeared after KTx. Changes of Hb were faster in the LVH group than in non-LVH group. There was a negative association between the absence of Hb increase and diastolic blood pressure, LVMI, Early diastolic mitral annulus velocity to Early diastolic filling wave ratio (E/E'), and left atrial emptying volume index (LAEVI), while there was a positive association between LV ejection fraction (LVEF), LV global longitudinal strain, and LA strain. LVMI and changes in LVEF showed a negative correlation, whereas changes in LAEVI showed a positive correlation with the absence of Hb increase during the early period after KTx.Children with LVH have a lower level of Hb before KTx and a higher level of Hb increase at the early postoperative period following KTx. LVMI and changes in LVEF and LAEVI have predictive value in absence of Hb increase in pediatic KTx recipents.
Keywords: cardiac function, Kidney Transplantation, Anemia, Hemoglobin, pediatric
Received: 01 Aug 2024; Accepted: 28 Feb 2025.
Copyright: © 2025 Yue, Xiao, Fan, Li, Liu, Yao, Lin, Wu, Liu, Wang, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jun Li, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Cuiling Li, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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