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

Resource type
Journal Article
Authors/contributors
Title
Lymphopenia at the time of transplant is associated with short-term mortality after deceased donor liver transplantation
Abstract
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/μL), mid (500–1000/μL), and high ALC (>1000/μL). 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 180day mortality than mid and high ALC groups (83.1% vs 95.8% and 97.4%, respectively; low vs mid: P ¼ .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 ¼ .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 ¼ .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 ¼ .001). Pretransplant lymphopenia is associated with short-term mortality and a higher incidence of posttransplant infections in DDLT patients.
Publication
American Journal of Transplantation
Date
02/2023
Volume
23
Issue
2
Pages
248-256
Journal Abbr
American Journal of Transplantation
Accessed
4/2/23, 3:46 PM
ISSN
16006135
Language
en
Library Catalog
DOI.org (Crossref)
Citation
Kitajima, T., Rajendran, L., Lisznyai, E., Lu, M., Shamaa, T., Ivanics, T., Yoshida, A., Claasen, M. P. A. W., Abouljoud, M. S., Sapisochin, G., & Nagai, S. (2023). Lymphopenia at the time of transplant is associated with short-term mortality after deceased donor liver transplantation. American Journal of Transplantation, 23(2), 248–256. https://doi.org/10.1016/j.ajt.2022.11.004
SOLID ORGANS AND MCSS
Link to this record