Outcomes among CMV‐mismatched and highly sensitized kidney transplants recipients who develop neutropenia

Limited data exist on the incidence and clinical outcomes of neutropenia among kidney transplant recipients. Our study included 572 adults who received a kidney transplant at the University of California, San Francisco Medical Center between 2012 and 2018, and were CMV‐mismatched or had a PRA ≥ 80%....

Full description

Saved in:
Bibliographic Details
Published in:Clinical transplantation 2022-04, Vol.36 (4), p.e14583-n/a
Main Authors: Brar, Sandeep, Berry, Reyoot, Raval, Amit D., Tang, Yuexin, Vincenti, Flavio, Skartsis, Nikolaos
Format: Article
Language:English
Subjects:
Adult
complication
Cytomegalovirus Infections - complications
Cytomegalovirus Infections - etiology
drug toxicity
Female
Graft Rejection - drug therapy
Graft Rejection - etiology
Humans
Kidney Transplantation - adverse effects
Middle Aged
mycophenolate mofetil
Neutropenia - drug therapy
Neutropenia - etiology
Retrospective Studies
side effects
Transplant Recipients
Valganciclovir - therapeutic use
valgancylcovir
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c3253-727a18fc5e9c57f2e39aca6289b08f8ad13e8661ae82f41a52960571b55a63213
cites cdi_FETCH-LOGICAL-c3253-727a18fc5e9c57f2e39aca6289b08f8ad13e8661ae82f41a52960571b55a63213
container_end_page n/a
container_issue 4
container_start_page e14583
container_title Clinical transplantation
container_volume 36
creator Brar, Sandeep
Berry, Reyoot
Raval, Amit D.
Tang, Yuexin
Vincenti, Flavio
Skartsis, Nikolaos
description Limited data exist on the incidence and clinical outcomes of neutropenia among kidney transplant recipients. Our study included 572 adults who received a kidney transplant at the University of California, San Francisco Medical Center between 2012 and 2018, and were CMV‐mismatched or had a PRA ≥ 80%. Recipients with HIV, Hepatitis B and C, and primary non‐function were excluded. Participants were followed for at least 1 year after transplantation. Neutropenia was defined as absolute neutrophil count 
doi_str_mv 10.1111/ctr.14583
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2616959762</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2616959762</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3253-727a18fc5e9c57f2e39aca6289b08f8ad13e8661ae82f41a52960571b55a63213</originalsourceid><addsrcrecordid>eNp1kEtOwzAQhi0EoqWw4ALIS1i0je3YiZeo4iUVVUKFbeQ6k9Y0L-yEqqw4AmfkJLgE2DGbGY0-_Zr5EDolwYj4GuvGjkjIY7aH-oRJOQwCQvdRP5AB9bNgPXTk3LPfCiL4IeqxUMZhxHgfrWdto6sCHFZFVS7x5P7p8_2jMK5QjV5BilWZ4pVZrvItdlA605g3v12btIQtbqwqXZ2rsnHYgja1gd24WVU4hVfIqxqX0Da2qqE06hgdZCp3cPLTB-jx-mo-uR1OZzd3k8vpUDPK2TCikSJxpjlIzaOMApNKK0FjuQjiLFYpYRALQRTENAuJ4lSKgEdkwbkSjBI2QOddbm2rlxZck_h_NOT-Tqhal1BvQXIZCerRiw7VtnLOQpbU1hTKbhMSJDu3iXebfLv17NlPbLsoIP0jf2V6YNwBG5PD9v-kZDJ_6CK_AJx7hb4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2616959762</pqid></control><display><type>article</type><title>Outcomes among CMV‐mismatched and highly sensitized kidney transplants recipients who develop neutropenia</title><source>Wiley</source><creator>Brar, Sandeep ; Berry, Reyoot ; Raval, Amit D. ; Tang, Yuexin ; Vincenti, Flavio ; Skartsis, Nikolaos</creator><creatorcontrib>Brar, Sandeep ; Berry, Reyoot ; Raval, Amit D. ; Tang, Yuexin ; Vincenti, Flavio ; Skartsis, Nikolaos</creatorcontrib><description>Limited data exist on the incidence and clinical outcomes of neutropenia among kidney transplant recipients. Our study included 572 adults who received a kidney transplant at the University of California, San Francisco Medical Center between 2012 and 2018, and were CMV‐mismatched or had a PRA ≥ 80%. Recipients with HIV, Hepatitis B and C, and primary non‐function were excluded. Participants were followed for at least 1 year after transplantation. Neutropenia was defined as absolute neutrophil count &lt; 1000 cells/μl. Cox proportional hazards regression models using neutropenia as a time‐varying predictor were used to determine the risk of mycophenolic acid and valganciclovir changes, rejection, hospitalizations and use of granulocyte colony stimulating factor. Models were adjusted for demographics and transplant characteristics. Mean follow‐up was 3.7 (SD, 1.8) years. The mean age of the cohort was 50.4 (13.1) years, and 57.5% were female. A total of 208 (36.3%) participants had neutropenia. Neutropenia was associated with an increased risk of valganciclovir or MPA dose reductions or discontinuations [adjusted hazard ratio, aHR: 7.78, 95% CI: 4.73–12.81], rejection [aHR 2.00, 95% CI: 1.10–3.64] and hospitalizations [aHR 3.32, 95% CI: 2.12–5.19]. Neutropenia occurs frequently after kidney transplantation and leads to more medication changes and adverse clinical outcomes.</description><identifier>ISSN: 0902-0063</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/ctr.14583</identifier><identifier>PMID: 34984735</identifier><language>eng</language><publisher>Denmark</publisher><subject>Adult ; complication ; Cytomegalovirus Infections - complications ; Cytomegalovirus Infections - etiology ; drug toxicity ; Female ; Graft Rejection - drug therapy ; Graft Rejection - etiology ; Humans ; Kidney Transplantation - adverse effects ; Middle Aged ; mycophenolate mofetil ; Neutropenia - drug therapy ; Neutropenia - etiology ; Retrospective Studies ; side effects ; Transplant Recipients ; Valganciclovir - therapeutic use ; valgancylcovir</subject><ispartof>Clinical transplantation, 2022-04, Vol.36 (4), p.e14583-n/a</ispartof><rights>2022 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3253-727a18fc5e9c57f2e39aca6289b08f8ad13e8661ae82f41a52960571b55a63213</citedby><cites>FETCH-LOGICAL-c3253-727a18fc5e9c57f2e39aca6289b08f8ad13e8661ae82f41a52960571b55a63213</cites><orcidid>0000-0001-9874-4574</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34984735$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brar, Sandeep</creatorcontrib><creatorcontrib>Berry, Reyoot</creatorcontrib><creatorcontrib>Raval, Amit D.</creatorcontrib><creatorcontrib>Tang, Yuexin</creatorcontrib><creatorcontrib>Vincenti, Flavio</creatorcontrib><creatorcontrib>Skartsis, Nikolaos</creatorcontrib><title>Outcomes among CMV‐mismatched and highly sensitized kidney transplants recipients who develop neutropenia</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>Limited data exist on the incidence and clinical outcomes of neutropenia among kidney transplant recipients. Our study included 572 adults who received a kidney transplant at the University of California, San Francisco Medical Center between 2012 and 2018, and were CMV‐mismatched or had a PRA ≥ 80%. Recipients with HIV, Hepatitis B and C, and primary non‐function were excluded. Participants were followed for at least 1 year after transplantation. Neutropenia was defined as absolute neutrophil count &lt; 1000 cells/μl. Cox proportional hazards regression models using neutropenia as a time‐varying predictor were used to determine the risk of mycophenolic acid and valganciclovir changes, rejection, hospitalizations and use of granulocyte colony stimulating factor. Models were adjusted for demographics and transplant characteristics. Mean follow‐up was 3.7 (SD, 1.8) years. The mean age of the cohort was 50.4 (13.1) years, and 57.5% were female. A total of 208 (36.3%) participants had neutropenia. Neutropenia was associated with an increased risk of valganciclovir or MPA dose reductions or discontinuations [adjusted hazard ratio, aHR: 7.78, 95% CI: 4.73–12.81], rejection [aHR 2.00, 95% CI: 1.10–3.64] and hospitalizations [aHR 3.32, 95% CI: 2.12–5.19]. Neutropenia occurs frequently after kidney transplantation and leads to more medication changes and adverse clinical outcomes.</description><subject>Adult</subject><subject>complication</subject><subject>Cytomegalovirus Infections - complications</subject><subject>Cytomegalovirus Infections - etiology</subject><subject>drug toxicity</subject><subject>Female</subject><subject>Graft Rejection - drug therapy</subject><subject>Graft Rejection - etiology</subject><subject>Humans</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Middle Aged</subject><subject>mycophenolate mofetil</subject><subject>Neutropenia - drug therapy</subject><subject>Neutropenia - etiology</subject><subject>Retrospective Studies</subject><subject>side effects</subject><subject>Transplant Recipients</subject><subject>Valganciclovir - therapeutic use</subject><subject>valgancylcovir</subject><issn>0902-0063</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kEtOwzAQhi0EoqWw4ALIS1i0je3YiZeo4iUVVUKFbeQ6k9Y0L-yEqqw4AmfkJLgE2DGbGY0-_Zr5EDolwYj4GuvGjkjIY7aH-oRJOQwCQvdRP5AB9bNgPXTk3LPfCiL4IeqxUMZhxHgfrWdto6sCHFZFVS7x5P7p8_2jMK5QjV5BilWZ4pVZrvItdlA605g3v12btIQtbqwqXZ2rsnHYgja1gd24WVU4hVfIqxqX0Da2qqE06hgdZCp3cPLTB-jx-mo-uR1OZzd3k8vpUDPK2TCikSJxpjlIzaOMApNKK0FjuQjiLFYpYRALQRTENAuJ4lSKgEdkwbkSjBI2QOddbm2rlxZck_h_NOT-Tqhal1BvQXIZCerRiw7VtnLOQpbU1hTKbhMSJDu3iXebfLv17NlPbLsoIP0jf2V6YNwBG5PD9v-kZDJ_6CK_AJx7hb4</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Brar, Sandeep</creator><creator>Berry, Reyoot</creator><creator>Raval, Amit D.</creator><creator>Tang, Yuexin</creator><creator>Vincenti, Flavio</creator><creator>Skartsis, Nikolaos</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9874-4574</orcidid></search><sort><creationdate>202204</creationdate><title>Outcomes among CMV‐mismatched and highly sensitized kidney transplants recipients who develop neutropenia</title><author>Brar, Sandeep ; Berry, Reyoot ; Raval, Amit D. ; Tang, Yuexin ; Vincenti, Flavio ; Skartsis, Nikolaos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3253-727a18fc5e9c57f2e39aca6289b08f8ad13e8661ae82f41a52960571b55a63213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>complication</topic><topic>Cytomegalovirus Infections - complications</topic><topic>Cytomegalovirus Infections - etiology</topic><topic>drug toxicity</topic><topic>Female</topic><topic>Graft Rejection - drug therapy</topic><topic>Graft Rejection - etiology</topic><topic>Humans</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Middle Aged</topic><topic>mycophenolate mofetil</topic><topic>Neutropenia - drug therapy</topic><topic>Neutropenia - etiology</topic><topic>Retrospective Studies</topic><topic>side effects</topic><topic>Transplant Recipients</topic><topic>Valganciclovir - therapeutic use</topic><topic>valgancylcovir</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brar, Sandeep</creatorcontrib><creatorcontrib>Berry, Reyoot</creatorcontrib><creatorcontrib>Raval, Amit D.</creatorcontrib><creatorcontrib>Tang, Yuexin</creatorcontrib><creatorcontrib>Vincenti, Flavio</creatorcontrib><creatorcontrib>Skartsis, Nikolaos</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brar, Sandeep</au><au>Berry, Reyoot</au><au>Raval, Amit D.</au><au>Tang, Yuexin</au><au>Vincenti, Flavio</au><au>Skartsis, Nikolaos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes among CMV‐mismatched and highly sensitized kidney transplants recipients who develop neutropenia</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2022-04</date><risdate>2022</risdate><volume>36</volume><issue>4</issue><spage>e14583</spage><epage>n/a</epage><pages>e14583-n/a</pages><issn>0902-0063</issn><eissn>1399-0012</eissn><abstract>Limited data exist on the incidence and clinical outcomes of neutropenia among kidney transplant recipients. Our study included 572 adults who received a kidney transplant at the University of California, San Francisco Medical Center between 2012 and 2018, and were CMV‐mismatched or had a PRA ≥ 80%. Recipients with HIV, Hepatitis B and C, and primary non‐function were excluded. Participants were followed for at least 1 year after transplantation. Neutropenia was defined as absolute neutrophil count &lt; 1000 cells/μl. Cox proportional hazards regression models using neutropenia as a time‐varying predictor were used to determine the risk of mycophenolic acid and valganciclovir changes, rejection, hospitalizations and use of granulocyte colony stimulating factor. Models were adjusted for demographics and transplant characteristics. Mean follow‐up was 3.7 (SD, 1.8) years. The mean age of the cohort was 50.4 (13.1) years, and 57.5% were female. A total of 208 (36.3%) participants had neutropenia. Neutropenia was associated with an increased risk of valganciclovir or MPA dose reductions or discontinuations [adjusted hazard ratio, aHR: 7.78, 95% CI: 4.73–12.81], rejection [aHR 2.00, 95% CI: 1.10–3.64] and hospitalizations [aHR 3.32, 95% CI: 2.12–5.19]. Neutropenia occurs frequently after kidney transplantation and leads to more medication changes and adverse clinical outcomes.</abstract><cop>Denmark</cop><pmid>34984735</pmid><doi>10.1111/ctr.14583</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9874-4574</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0902-0063
ispartof Clinical transplantation, 2022-04, Vol.36 (4), p.e14583-n/a
issn 0902-0063
1399-0012
language eng
recordid cdi_proquest_miscellaneous_2616959762
source Wiley
subjects Adult
complication
Cytomegalovirus Infections - complications
Cytomegalovirus Infections - etiology
drug toxicity
Female
Graft Rejection - drug therapy
Graft Rejection - etiology
Humans
Kidney Transplantation - adverse effects
Middle Aged
mycophenolate mofetil
Neutropenia - drug therapy
Neutropenia - etiology
Retrospective Studies
side effects
Transplant Recipients
Valganciclovir - therapeutic use
valgancylcovir
title Outcomes among CMV‐mismatched and highly sensitized kidney transplants recipients who develop neutropenia
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-11T16%3A21%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Outcomes%20among%20CMV%E2%80%90mismatched%20and%20highly%20sensitized%20kidney%20transplants%20recipients%20who%20develop%20neutropenia&rft.jtitle=Clinical%20transplantation&rft.au=Brar,%20Sandeep&rft.date=2022-04&rft.volume=36&rft.issue=4&rft.spage=e14583&rft.epage=n/a&rft.pages=e14583-n/a&rft.issn=0902-0063&rft.eissn=1399-0012&rft_id=info:doi/10.1111/ctr.14583&rft_dat=%3Cproquest_cross%3E2616959762%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3253-727a18fc5e9c57f2e39aca6289b08f8ad13e8661ae82f41a52960571b55a63213%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2616959762&rft_id=info:pmid/34984735&rfr_iscdi=true