Lymphopenia at the time of transplant is associated with short-term mortality after deceased donor liver transplantation

Kitajima, ToshihiroHenry Ford Hlth Syst, Dept Transplant & Hepatobiliary Surg, Detroit, MI USA. (author)

Absolute lymphocyte count (ALC) is considered a surrogate marker for nutritional status and immunocompetence. We investigated the association between ALC and post-liver transplant outcomes in patients who received a deceased donor liver transplant (DDLT). Patients were categorized by ALC at liver transplant: low (<500/mu L), mid (500-1000/mu L), and high ALC (>1000/mu L). Our main analysis used retrospective data (2013-2018) for DDLT recipients from Henry Ford Hospital (United States); the results were further validated using data from the Toronto General Hospital (Canada). Among 449 DDLT recipients, the low ALC group demonstrated higher 180-day mortality than mid and high ALC groups (83.1% vs 95.8% and 97.4%, respectively; low vs mid: P =.001; low vs high: P <.001). A larger proportion of patients with low ALC died of sepsis compared with the combined mid/high groups (9.1% vs 0.8%; P <.001). In multivariable analysis, pretransplant ALC was associated with 180-day mortality (hazard ratio, 0.20; P =.004). Patients with low ALC had higher rates of bacteremia (22.7% vs 8.1%; P <.001) and cytomegaloviremia (15.2% vs 6.8%; P =.03) than patients with mid/high ALC. Low ALC pretransplant through postoperative day 30 was associated with 180-day mortality among patients who received rabbit antithymocyte globulin induction (P =.001). Pretransplant lymphopenia is associated with short-term mortality and a higher incidence of posttransplant infections in DDLT patients.

Rajendran, LuckshiUniv Toronto, Dept Surg, Div Gen Surg, Toronto, ON, Canada. (author)
Lisznyai, EricHenry Ford Hlth Syst, Dept Transplant & Hepatobiliary Surg, Detroit, MI USA. (author)
Lu, MeiHenry Ford Hlth Syst, Dept Publ Hlth Sci, Detroit, MI USA. (author)
Shamaa, TayseerHenry Ford Hlth Syst, Dept Transplant & Hepatobiliary Surg, Detroit, MI USA. (author)
Ivanics, TommyUppsala universitet,Gastrointestinalkirurgi,Henry Ford Hlth Syst, Dept Transplant & Hepatobiliary Surg, Detroit, MI USA.;Univ Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.(Swepub:uu)tomiv601 (author)
Yoshida, AtsushiHenry Ford Hlth Syst, Dept Transplant & Hepatobiliary Surg, Detroit, MI USA. (author)
Claasen, Marco P. A. W.Univ Toronto, Multiorgan Transplant Program, Toronto, ON, Canada. (author)
Abouljoud, Marwan S.Henry Ford Hlth Syst, Dept Transplant & Hepatobiliary Surg, Detroit, MI USA. (author)
Sapisochin, GonzaloUniv Toronto, Dept Surg, Div Gen Surg, Toronto, ON, Canada.;Univ Toronto, Multiorgan Transplant Program, Toronto, ON, Canada. (author)
Nagai, ShunjiHenry Ford Hlth Syst, Dept Transplant & Hepatobiliary Surg, Detroit, MI USA.;2799 Grand Blvd,CFP 2, Detroit, MI 48202 USA. (author)
Henry Ford Hlth Syst, Dept Transplant & Hepatobiliary Surg, Detroit, MI USA.Univ Toronto, Dept Surg, Div Gen Surg, Toronto, ON, Canada. (creator_code:org_t)

In:American Journal of Transplantation: Elsevier BV23:2, s. 248-2561600-61351600-6143

By the author/editor: Kitajima, Toshih ...; Rajendran, Lucks ...; Lisznyai, Eric; Lu, Mei; Shamaa, Tayseer; Ivanics, Tommy; show more...; Yoshida, Atsushi; Claasen, Marco P ...; Abouljoud, Marwa ...; Sapisochin, Gonz ...; Nagai, Shunji; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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