HHS Public Access Author manuscript Author Manuscript
Liver Transpl. Author manuscript; available in PMC 2017 February 01. Published in final edited form as: Liver Transpl. 2016 February ; 22(2): 217–225. doi:10.1002/lt.24332.
Characteristics and Outcomes of Neutropenia after Orthotopic Liver Transplantation B Alraddadi, MD, MSc1, NE Nierenberg, MD, MPH2, LL Price, MAS2,3, JKL Chow, MD, MS2, DD Poutsiaka, MD, PhD2, RJ Rohrer, MD, FACS2, JT Cooper, MD2, RB Freeman, MD, FACS4, and DR Snydman, MD, FACP, FIDSA2 1King
Author Manuscript
2Tufts
Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia Medical Center, Tufts University School of Medicine, Boston, MA, USA
3The
Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, and Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
4Dartmouth-Hitchcock
Medical Center, Dartmouth College, New Lebanon, NH, USA
Abstract
Author Manuscript
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] less than or equal to 1000/mm3) 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, blood stream infection (BSI), invasive fungal infection (IFI), 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 less than 500/mm3). The following were independent predictors for neutropenia: Child-TurcottePugh score (HR 1.15; 95% CI 1.02, 1.28; p=0.02), BSI (HR 2.89; 95% CI 1.64, 5.11; p=
Liver Transpl. Author manuscript; available in PMC 2017 February 01. Published in final edited form as: Liver Transpl. 2016 February ; 22(2): 217–225. doi:10.1002/lt.24332.
Characteristics and Outcomes of Neutropenia after Orthotopic Liver Transplantation B Alraddadi, MD, MSc1, NE Nierenberg, MD, MPH2, LL Price, MAS2,3, JKL Chow, MD, MS2, DD Poutsiaka, MD, PhD2, RJ Rohrer, MD, FACS2, JT Cooper, MD2, RB Freeman, MD, FACS4, and DR Snydman, MD, FACP, FIDSA2 1King
Author Manuscript
2Tufts
Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia Medical Center, Tufts University School of Medicine, Boston, MA, USA
3The
Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, and Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
4Dartmouth-Hitchcock
Medical Center, Dartmouth College, New Lebanon, NH, USA
Abstract
Author Manuscript
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] less than or equal to 1000/mm3) 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, blood stream infection (BSI), invasive fungal infection (IFI), 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 less than 500/mm3). The following were independent predictors for neutropenia: Child-TurcottePugh score (HR 1.15; 95% CI 1.02, 1.28; p=0.02), BSI (HR 2.89; 95% CI 1.64, 5.11; p=
