Introduction: Neutropenia is relatively frequent after solid organ transplantation (SOT). Its risk factors have been scarcely studied and its consequences remain to be defined in SOT patients (pts). Purpose: To identify risk factors for neutropenia and correlations between neutropenia and infection, acute rejection (AR) and pt survival in SOT pts. Methods: We performed a retrospective database analysis of 1159 pts with SOT (kidney, liver, pancreas or kidney-pancreas) from Jan 2000 to Feb 2011. Results: Multivariate analysis showed that liver (OR 2.66, CI: 1.93-3.67) and kidney-pancreas Tx (OR 1.77, CI: 1.04-3.04), positive donor CMV status (OR 1.73, CI: 1.32-2.27), thrombocytopenia (OR 3.89, CI: 1.45-10.39), use of azathioprine (OR 2.09, CI: 1.34-3.25) and valganciclovir (OR 1.89, CI: 1.44-2.49), were risk factors for neutropenia. Neutropenic pts (86.8%) developed more infections vs. non-neutropenic pts (71.7%, p<0.001). Neutropenia was associated with a higher rate of AR (17.3% vs. 12.0%; p=0.025, Fig.1) as well as a higher risk of mortality (26.6% vs. 16.7%, p=0.02, Fig.2). Conclusion: To the best of our knowledge, this study is the first to demonstrate a differential risk for neutropenia among recipients of different SOT. We demonstrate that neutropenia is associated with increased risk of infections, AR and all-cause mortality.

Figure 1: AR rate during the first year posttransplantation shows higher rate of AR in neutropenic pts (p=0.025).

Figure 2: Overall survival rate shows longer overall survival of non-neutropenic pts (p=0.02).

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