Characteristics and outcomes of neutropenia after orthotopic liver transplantation.

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Basem AlraddadiD R Snydman

Abstract

Neutropenia after orthotopic liver transplantation (LT) is relatively common, but the factors associated with its development remain elusive. We assessed possible predictors of neutropenia (absolute neutrophil count [ANC] ≤ 1000/mm(3) ) within the first year of LT in a cohort of 304 patients at a tertiary medical center between 1999 and 2009 using time-dependent survival analysis to identify risk factors for neutropenia. In addition, we analyzed neutropenia as a predictor of the clinical outcomes of death, bloodstream infection (BSI), invasive fungal infection, cytomegalovirus (CMV) disease, and graft rejection within the first year of LT. Of the 304 LT recipients, 73 (24%) developed neutropenia, 5 (7%) of whom had grade 4 neutropenia (ANC < 500/mm(3) ). The following were independent predictors for neutropenia: Child-Turcotte-Pugh score (hazard ratio [HR] 1.15; 95% confidence interval [CI], 1.03-1.30; P = 0.02), BSI (HR, 2.89; 95% CI, 1.63-5.11; P < 0.001), CMV disease (HR, 4.28; 95% CI, 1.55-11.81; P = 0.005), baseline tacrolimus trough level (HR, 1.02; 95% CI, 1.01-1.03; P = 0.007), and later era LT (2004-2009 versus 1999-2003; HR, 2.28; 95% CI, 1.43-3.65; P < 0.001). Moreover, neutropenia was found to be an independent pred...Continue Reading

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Citations

Feb 24, 2018·Pediatric Transplantation·Kirsten Rose-FelkerWilliam T Mahle
Jul 25, 2017·Clinical Transplantation·Thomas A MavrakanasMarcelo Cantarovich
Aug 28, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Laneshia Karee TagueAndrew E Gelman
Mar 7, 2020·The Journal of Infectious Diseases·Ghady HaidarNina Singh
Sep 8, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Jessica LumChristine E Koval
May 14, 2021·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Jennifer K L ChowDavid R Snydman
Jul 30, 2021·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Dina Leth MøllerSusanne Dam Nielsen
Sep 9, 2021·Pediatric Transplantation·Chaowapong JarasvaraparnSakil Kulkarni
May 31, 2019·Current Opinion in Organ Transplantation·Jonathan Hand, Gopi Patel

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