Characteristics, risk factors, and outcomes of neutropenia after liver or kidney transplantation in children

Background While prior adult studies have shown that approximately 20%–38% of subjects undergoing solid‐organ transplant develop neutropenia, similar analyses in pediatric subjects are scarce. Methods We conducted a retrospective chart review of liver transplant (LT) and kidney transplant (KT) recip...

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Published in:Pediatric transplantation Vol. 26; no. 1; pp. e14131 - n/a
Main Authors: Jarasvaraparn, Chaowapong, Choudhury, Shelley, Rusch, Courtney, Nadler, Michelle, Liss, Kim H. H., Stoll, Janis, Hmiel, Stanley, Khan, Adeel, Doyle, Maria, Kulkarni, Sakil
Format: Journal Article
Language:English
Published: Denmark Wiley Subscription Services, Inc 01-02-2022
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Summary:Background While prior adult studies have shown that approximately 20%–38% of subjects undergoing solid‐organ transplant develop neutropenia, similar analyses in pediatric subjects are scarce. Methods We conducted a retrospective chart review of liver transplant (LT) and kidney transplant (KT) recipients at our center during the period 2008–2018. All of the KT and none of the LT subjects during this time period had induction with either anti‐thymocyte globulin (ATG) or basiliximab at time of transplant. Neutropenia was defined as absolute neutrophil count (ANC) value ≤1000/mm3. Results One hundred subjects with LT and 82 subjects with KT were included. The incidence of neutropenia within the first year of transplant in KT was higher compared to LT (54.8% vs 39%, p = .01). The median number of hospitalizations (p = .001) and infectious complications (p = .04) was significantly higher only in the KT subjects who developed neutropenia (compared to those who did not). Multivariate analysis identified factors associated with severity of liver disease at transplant, namely h/o upper gastrointestinal bleeding (p = .02), weight deficit (p = .01), and pre‐LT ANC (p = .01), along with high or moderate risk cytomegalovirus status (p = .05) as predictors of neutropenia in LT subjects. Female gender (p = .03) predicted neutropenia, while BK virus infection was protective for neutropenia (p = .04) in KT subjects. Conclusions The incidence of and morbidity associated with neutropenia within 1 year post‐transplant is higher in KT subjects compared to LT subjects. The likely reason for this is the use of induction therapy (ATG, basiliximab) at the time of transplant in KT subjects.
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SC: participated in review of literature, acquisition of data, preparation of manuscript and approved the final manuscript as submitted.
KL: conceptualized and designed the study, critically reviewed and approved the final manuscript as submitted.
MD: conceptualized and designed the study, critically reviewed and approved the final manuscript as submitted
CJ: a principal investigator, had original idea of the study, conceptualized, participated in review of literature, designed the study, acquisition of data, data analysis and interpretation, drafted the initial manuscript, and approved the final manuscript as submitted.
CR: participated in review of literature, acquisition of data, preparation of manuscript and approved the final manuscript as submitted.
MN: conceptualized and designed the study, critically reviewed and approved the final manuscript as submitted.
Authorship
SH: conceptualized and designed the study, critically reviewed and approved the final manuscript as submitted.
AK: conceptualized and designed the study, critically reviewed and approved the final manuscript as submitted.
SK: conceptualized and designed the study, participated in review of literature, data analysis and interpretation, critically reviewed and approved the final manuscript as submitted.
JS: conceptualized and designed the study, critically reviewed and approved the final manuscript as submitted.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.14131