Heart transplant

Iron homeostasis in heart transplant recipients randomized to receive ferric derisomaltose or placebo

This article was originally published here

Clin Registry. May 9, 2022: e14695. doi: 10.1111/ctr.14695. Online ahead of print.

ABSTRACT

INTRODUCTION: The randomized IronIC trial evaluated the effect of intravenous ferric derisomaltosis on exercise capacity in iron-deficient maintenance heart transplant (HTx) recipients. Iron deficiency was defined as heart failure with elevated ferritin thresholds to compensate for inflammation. However, intravenous iron did not improve physical capacity except in patients with ferritin

Methods: We assessed key regulators of iron homeostasis, such as hepcidin, soluble transferrin receptor (sTfR), and interleukin-6 (IL-6). We also measured growth factors and inflammatory markers relevant to iron metabolism. The results were compared with those of 21 healthy controls.

RESULTS: Hepcidin did not differ between HTx recipients and controls, although inflammatory markers were mildly elevated. However, HTx recipients with ferritin

CONCLUSION: HTx recipients with iron deficiency as defined in heart failure do not have elevated hepcidin levels, although inflammatory markers are slightly increased. The high ferritin thresholds used in heart failure may not be suitable for defining iron deficiency in the HTx population. We suggest that hepcidin and sTfR be measured to identify patients with true iron deficiency who may benefit from intravenous iron therapy. This article is protected by copyright. All rights reserved.

PMID:35532871 | DOI: 10.1111/ctr.14695