Induction therapy, tacrolimus plasma concentration, and duration of intensive care unit stay are risk factors for peripheral leucopenia following heart transplantation
Tomasz Urbanowicz, Ewa Straburzyńska-Migaj, Aneta Klotzka, Hanna Baszyńska-Wachowiak, Marcin Misterski, Stefan Grajek, Marek Jemielity
Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland
Ann Transplant 2014; 19:494-498
Available online: 2014-10-02
Although survival among heart recipients has increased, a limiting factor is chronic adverse effects of immunosuppression therapy.
Material and Methods: We performed a retrospective analysis of 22 patients (19 men and 3 women) with a mean age of 48±12 years who underwent orthotropic heart transplantation. There were 20 (91%) patients who received induction therapy (basiliximab, Simulect, Novartis Europharm Limited). All patients were treated with standard triple immunosuppressive regimen (tacrolimus, mycophenolate mofetil, and steroids).
Results: Patients were divided into 2 groups according to postoperative peripheral cytopenia diagnosis. There were 16 (73%) in the cytopenic group and 6 (27%) in the non-cytopenic group. Mean time of peripheral leucopenia detection was 65±13 days following surgery. The blood leucocyte count was 0.98±0.2×10^3/mm3 vs. 5.85±0.9×10^3/mm3 in patients with peripheral cytopenia compared to non-cytopenic patients (p<0.01). There was a statistically important difference in duration of intensive care unit stay between the 2 groups (p<0.01). A correlation between tacrolimus serum concentration and risk for leucopenia was also detected (p<0.05).
Conclusions: Basiliximab administration as induction therapy, tacrolimus serum concentration, and duration of intensive care unit stay are risk factors for leucopenia.
Keywords: Antibodies, Monoclonal, Heart Transplantation, Intensive Care, Tacrolimus