Neutropenia in kidney and liver transplant recipients: Risk factors and outcomes

No studies have directly compared the key characteristics and outcomes of kidney ( KT x) and liver transplantation ( LT x) recipients with neutropenia. In this single‐center, retrospective, cohort study, we enrolled all adult patients who received a KT x or LT x between 2000 and 2011. Neutropenia was defined as 2 consecutive absolute neutrophil count ( ANC ) values <1500/mm 3 in patients without preexisting neutropenia. The first neutropenia episode occurring during the first year post‐transplantation was analyzed. A total of 663 patients with KT x and 354 patients with LT x met the inclusion criteria. Incidence of neutropenia was 20% in KT x and 38% in LT x, respectively. High‐risk CMV status and valganciclovir ( VGCV ) use were significant predictors of neutropenia for KT x recipients, but only VGCV use vs nonuse in LT x recipients. Neutropenia was associated with worse survival in KT x recipients (adjusted HR 1.95, 95% CI 1.18‐3.22, P <.01), but not in LT x recipients (adjusted HR 0.75, 95% CI 0.52‐1.10, P =.15). Sixteen acute rejection episodes were associated with preceding neutropenia in KT x recipients ( HR 1.77, 95% CI 1.16‐2.68, P =.007) and 24 acute rejection episodes in LT x recipients ( HR 1.41, 95% CI 0.97‐2.04, P =.07). Incidence of infection was similar in patients with and without neutropenia among KT x and LT x recipients.