Absolute Lymphocyte Count as a Marker for Cytomegalovirus Infection After Heart Transplantation.


Journal

Transplantation
ISSN: 1534-6080
Titre abrégé: Transplantation
Pays: United States
ID NLM: 0132144

Informations de publication

Date de publication:
01 03 2023
Historique:
pubmed: 14 10 2022
medline: 25 2 2023
entrez: 13 10 2022
Statut: ppublish

Résumé

Previous studies indicate an association between reduced absolute lymphocyte count (ALC) and cytomegalovirus (CMV) infection after solid organ transplantation and have therefore highlighted the potential of ALC as a simple tool to predict CMV infection in transplant patients. This study aimed to examine the utility of ALC as a valuable marker for CMV infection in heart transplant patients. Clinical information and ALC data of all adult patients who received orthotopic heart transplantation at the Medical University of Vienna between January 2004 and May 2019 were collected. We performed a multivariable Cox regression model that incorporates repeated measurements of ALC as a time-varying continuous factor in 2 ways, first as continuous logarithmic factor considering a 50% decrease of ALC levels and second as binary factor using a threshold of 610 cells/μL. One hundred fifty-eight (39%) patients developed CMV infection over the course of 2 y. Patients with lymphopenia were shown to be at higher risk of developing CMV infection both in the continuous approach (HR [per 50% reduction] 1.29; confidence interval [CI], 1.09-1.53; P = 0.003) and the binary approach with a cutoff of 610 cells/μL (HR 1.74; CI, 1.20-2.51; P = 0.003). This study demonstrated a strong association between reduced ALC and the development of CMV infection after heart transplantation. ALC value monitoring could provide an additional tool to assess individualized CMV risk after solid organ transplantation.

Sections du résumé

BACKGROUND
Previous studies indicate an association between reduced absolute lymphocyte count (ALC) and cytomegalovirus (CMV) infection after solid organ transplantation and have therefore highlighted the potential of ALC as a simple tool to predict CMV infection in transplant patients. This study aimed to examine the utility of ALC as a valuable marker for CMV infection in heart transplant patients.
METHODS
Clinical information and ALC data of all adult patients who received orthotopic heart transplantation at the Medical University of Vienna between January 2004 and May 2019 were collected. We performed a multivariable Cox regression model that incorporates repeated measurements of ALC as a time-varying continuous factor in 2 ways, first as continuous logarithmic factor considering a 50% decrease of ALC levels and second as binary factor using a threshold of 610 cells/μL.
RESULTS
One hundred fifty-eight (39%) patients developed CMV infection over the course of 2 y. Patients with lymphopenia were shown to be at higher risk of developing CMV infection both in the continuous approach (HR [per 50% reduction] 1.29; confidence interval [CI], 1.09-1.53; P = 0.003) and the binary approach with a cutoff of 610 cells/μL (HR 1.74; CI, 1.20-2.51; P = 0.003).
CONCLUSIONS
This study demonstrated a strong association between reduced ALC and the development of CMV infection after heart transplantation. ALC value monitoring could provide an additional tool to assess individualized CMV risk after solid organ transplantation.

Identifiants

pubmed: 36228318
doi: 10.1097/TP.0000000000004360
pii: 00007890-202303000-00030
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

748-752

Informations de copyright

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare no funding or conflicts of interest.

Références

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Auteurs

Armin-Kai Schoeberl (AK)

Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.

Andreas Zuckermann (A)

Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.

Alexandra Kaider (A)

Department of Clinical Biometrics, Center for Medical Statistics, Informatics, and Intelligent Systems (CeMSIIS), Medical University of Vienna, Vienna, Austria.

Arezu Aliabadi-Zuckermann (A)

Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.

Keziban Uyanik-Uenal (K)

Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.

Guenther Laufer (G)

Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.

Johannes Goekler (J)

Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.

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