Neutropenia in Kidney and Liver Transplant Recipients: Risk Factors and Consequences.
1Medicine, Division of Nephrology, McGill University Health Center, Montreal, QC, Canada
2Pharmacy, McGill University Health Center, Montreal, QC, Canada
3Medicine, Division of Infectious Diseases, McGill University Health Center, Montreal, QC, Canada
4Medicine, Division of Nephrology, Multi-Organ Transplant Program, McGill University Health Center, Montreal, QC, Canada
Meeting: 2017 American Transplant Congress
Abstract number: A211
Keywords: Infection, Kidney transplantation, Liver transplantation, Neutropenia
Session Information
Session Name: Poster Session A: Kidney Complications I
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Aim: This study aimed to: 1) Define the risk factors associated with neutropenia within the first year post kidney or liver transplantation; 2) Describe the association between neutropenia and patient survival, infection, or acute rejection.
Methods: In this single-center, retrospective, cohort study, we enrolled all adult patients who received a kidney (KTx) or liver transplantation (LTx) between 2000 and 2011. Neutropenia was defined as two consecutive absolute neutrophil count (ANC) values lower than 1500/mm3. The first neutropenia episode occurring during the first-year posttransplantation was analyzed. Patients with neutropenia at baseline were excluded.
Results: 663 patients with KTx and 354 patients with LTx met the inclusion criteria, with median follow-up of 55 months. The incidence of neutropenia was 20% and 38%, respectively. The median time to onset of neutropenia was 91 and 78 days, the median lowest ANC was 790 and 900/mm3, and the median duration of each episode was 14 days in both groups. Induction therapy with anti-thymocyte globulin or basiliximab, as well as use of valganciclovir (VGCV) were significant predictors of neutropenia for KTx recipients, but only VGCV use versus non-use in LTx recipients. Neutropenia was associated with worse survival in KTx recipients (HR 2.04, 95% CI 1.24-3.37), but not in LTx recipients (HR 0.80, 95% CI 0.55-1.16). Sixteen acute rejection episodes were associated with preceding neutropenia in KTx recipients (HR 1.77, 95% CI 1.16-2.68), but only two of them led to graft loss. Twenty-four acute rejection episodes were associated with preceding neutropenia in LTx recipients (HR 1.41, 95% CI 0.97-2.04), but only one led to graft loss. The incidence of infectious episodes (urinary tract infections, bacteremias, pneumonias, CMV disease, and polyoma virus viremia) was similar in patients with and without neutropenia among KTx and LTx recipients.
Conclusion: Neutropenia in the first year following transplant is associated with worse patient survival, and higher acute rejection rates in KTx transplant recipients, but not in LTx recipients. Further work is required to understand this relationship.
CITATION INFORMATION: Mavrakanas T, Fournier M, Clairou S, Amiel J, Vinh D, Coursol C, Thirion D, Cantarovich M. Neutropenia in Kidney and Liver Transplant Recipients: Risk Factors and Consequences. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Mavrakanas T, Fournier M, Clairou S, Amiel J, Vinh D, Coursol C, Thirion D, Cantarovich M. Neutropenia in Kidney and Liver Transplant Recipients: Risk Factors and Consequences. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/neutropenia-in-kidney-and-liver-transplant-recipients-risk-factors-and-consequences/. Accessed May 17, 2025.« Back to 2017 American Transplant Congress