1. ¹Division of Nephrology, Winthrop-University Hospital, Mineola, New York, USA
2. ²Division of Nephrology, Columbia University Medical Center, New York, New York, USA
3. ³Division of Renal Diseases, Washington University School of Medicine, St Louis, Missouri, USA
4. ⁴Department of Medicine, Nephrology Section, University of Wisconsin-Madison, Madison, Wisconsin, USA
5. ⁵Renal Division, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
6. ⁶Division of Nephrology, University Hospitals Case Medical Center, Cleveland, Ohio, USA

Correspondence: Steven Fishbane, Division of Nephrology, Winthrop-University Hospital, 200 Old Country Road, Mineola, New York 11501, USA. E-mail: sfishbane@winthrop.org

Received 3 September 2008; Revised 13 March 2009; Accepted 7 April 2009; Published online 24 June 2009.

Abstract

Posttransplant anemia is a common problem that may hinder patients' quality of life. It occurs in 12 to 76% of patients, and is most common in the immediate posttransplant period. A variety of factors have been identified that increase the risk of posttransplant anemia, of which the level of renal function is most important. Sirolimus, a mammalian target of rapamycin inhibitor, has been implicated as playing a special role in posttransplant anemia. This review considers anemia associated with sirolimus, including its presentation, mechanisms, and management.