Recovery from anti-recombinant-human-erythropoietin associated pure red cell aplasia in end-stage renal disease patients after renal transplantation

Since 1990, recombinant human erythropoietin(r-HuEPO) has been used for the treatment ofanaemia of chronic renal failure (CRF). Correction ofanaemia may improve cardiovascular as well as non-cardiovascular morbidity and mortality. Despite thesepotentially beneficial effects of r-HuEPO, some CRFpatients who have previously or are currently usingr-HuEPO have been reported to display suspected orconfirmed pure red cell aplasia (PRCA) [1,2]. Thesepatients developed an unexplained sudden decreasein their haemoglobin (Hgb) level. Anti-r-HuEPOantibody (Ab), which has been demonstrated in severalstudies [3–5], seems to be the proximate cause of thePRCA.Currently,thereisnofirmlyestablishedmanage-ment of anti-r-HuEPO associated with PRCA in CRFpatients. Cyclophosphamide and prednisolone appearto be ineffective [6]. We report here that anti-r-HuEPOassociated PRCA in end-stage renal disease (ESRD)patients was reversible after kidney transplantation.