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Does PTH Play a Role in Post Kidney Transplant Leukopenia?

R. Dhawan, L. Shin, K. Lee, B. Duong, L. Aguirre, C. Parke, S. Alexopoulos, M. Smogorzewski, A. Gomez, E. Mariscal, L. Matsuoka, Y. Qazi.

Division of Transplantation, University Of Southern California. Keck Med Center, Los Angeles, CA.

Meeting: 2015 American Transplant Congress

Abstract number: D34

Keywords: Bone marrow, Hyperparathyroidism, Kidney transplantation, Leukocytes

Session Information

Session Name: Poster Session D: Diabetes/Metabolic/Bone/Malignancy/Pregnancy

Session Type: Poster Session

Date: Tuesday, May 5, 2015

Session Time: 5:30pm-6:30pm

 Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Aim : Recent data suggests a role of Parathyroid hormone (PTH) on hematopoietic stem cell progenitor cells(HSPCs)[1,2]. The purpose of the study was determine the percentage of pts at our center within the guideline range of PTH in the current era of calcimimetic drugs and to assess if levels of PTH correlated to post transplant leukopenia. Methods: PTH and Alkaline Phosphatase (Aphos) levels at Tx and 3month WBC counts(WBC3mo) were obtained on all pts. Aphos was used as surrogate of PTH related bone turnover. The data was collected from Nov 2013 to Aug 2014. The PTH levels were stratified into groups; <50, 51-100,101-150, 151-300, 301-450,451-600,601-750,751-900,>900 to assess the effect to PTH levels on WBC3mo . KDIGO guideline levels 0f <150, 150-300, >300 was used to assess incidence. Aphos were classified as low if <65 and high if >130, leukopenia was defined as wbc <4.5 at 3 months. PTH was obtained on 120 pts at the time of Tx and 97 had all data points. Mean duration of dialysis was: 83 months. 82% of pts were induced with basiliximab .[/Results:] <150, 150-300,>300. 47/120 (40%). 32/120(26%), 41/120(34%). The number of pts in each of the following group <50, 51-100,101-150, 151-300, 301-450,451-600,601-750,751-900,>900 were 7,19,22,30, 27,6 and 6 respectively. The number of pts with low WBC3mo for same groups was 5,6,4,9,8,1,2 respectively and for Aphos was 5,6,4,9,8,1,2 respectively. Conclusion: Our study suggests that only 26% of pts at time of Tx were within the guideline range of 150-300 and about 40 % of pts had over suppressed PTH. Our study demonstrates that extremely Low PTH at Tx is a risk factor for developing post transplant leucopenia at WBC3mo. Data is being collected to see if PTH levels through its effect on HSPC's may also be a risk factor for rejection. References:(1).Minireview: Complexity of Hematopoietic Stem Cell Regulation in the Bone Marrow Microenvironment. Molecular endocrinology (Baltimore, Md.) 08/2014; DOI: 10.1210/me.2014-1079. (2). Brunner S, Theiss HD, Murr A, Negele T, Franz WM. Primary hyperparathyroidism is associated with increased circulating bone marrow-derived progenitor cells. Am J Physiol Endocrinol Metab. 2007;293(6):E1670–1675

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To cite this abstract in AMA style:

Dhawan R, Shin L, Lee K, Duong B, Aguirre L, Parke C, Alexopoulos S, Smogorzewski M, Gomez A, Mariscal E, Matsuoka L, Qazi Y. Does PTH Play a Role in Post Kidney Transplant Leukopenia? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/does-pth-play-a-role-in-post-kidney-transplant-leukopenia/. Accessed May 8, 2025.

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