Risk Factors and Management of Leukopenia After Kidney Transplantation: A Single-Center Experience

被引：5

作者：

Henningsen, Max ^{[1
]}

Jaenigen, Bernd ^{[2
]}

Zschiedrich, Stefan ^{[1
]}

Pisarski, Przemyslaw ^{[2
]}

Walz, Gerd ^{[1
]}

Schneider, Johanna ^{[1
]}

机构：

[1] Univ Freiburg, Med Ctr, Dept Med 4, Fac Med, Hugstetter Str 55, D-79106 Freiburg, Germany

[2] Univ Freiburg, Sect Transplant Surg, Med Ctr, Dept Gen & Digest Surg,Fac Med, Freiburg, Germany

来源：

TRANSPLANTATION PROCEEDINGS | 2021年 / 53卷 / 05期

关键词：

LATE-ONSET NEUTROPENIA; CYTOMEGALOVIRUS DISEASE; RECIPIENTS; THROMBOCYTOPENIA; ALLOPURINOL; VALGANCICLOVIR; AZATHIOPRINE; RITUXIMAB; IMPACT;

D O I：

10.1016/j.transproceed.2021.04.011

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Leukopenia is a common complication after kidney transplantation. The etiology is multifactorial, with medication adverse effects and cytomegalovirus infection as main causes. Optimal strategies to prevent or treat posttransplant leukopenia remain unknown. We aimed to identify risk factors for leukopenia and to investigate the benefit of switching the immunosuppressive therapy to hydrocortisone as a continuous infusion. Methods. We retrospectively evaluated all patients with leukopenia after kidney transplantation between 2007 and 2017 at our center relative to age- and sex-matched controls. Results. Leukopenia was associated with the degree of rejection therapy before leukopenia, the immunosuppressive therapy before transplantation, and an induction therapy with rabbit antithymocyte globulin. Patients with leukopenia exhibited increased mortality, an increased incidence of bacterial and viral infections, and more acute rejections. Switching to hydrocortisone as a continuous infusion in patients with severe leukopenia decreased the duration of leukopenia and the incidence of subsequent viral infections, especially with cytomegalovirus. Conclusion. Leukopenia is a risk factor for infectious complications and mortality, and it is associated with acute rejection. Switching immunosuppressive therapy to hydrocortisone as a continuous infusion is a safe approach to reduce the duration of leukopenia and the incidence of viral infections.

引用

页码：1589 / 1598

页数：10

共 32 条

[11] Management of leukopenia in kidney and pancreas transplant recipients [J].