Hospital Pharmacy Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain.
Pulmonology Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain.
Med Sci (Basel). 2024 Oct 16;12(4):56. doi: 10.3390/medsci12040056.
BACKGROUND/OBJECTIVES: Neutropenia is a frequent complication among solid organ transplant (SOT) recipients receiving immunosuppressive therapy and antimicrobial prophylaxis. However, there are limited studies analysing the frequency and impact of neutropenia in lung transplant recipients (LTRs). Our aim was to analyse the frequency of neutropenia, the need for granulocyte colony-stimulating factor (GCSF) treatment within the first 18 months post-transplant and its association with acute rejection, chronic lung allograft dysfunction (CLAD), overall survival and the development of infections.
This observational and retrospective study recruited 305 patients who underwent lung transplantation between 2009 and 2019, with outpatient quarterly follow-up during the first 18 months post-surgery.
During this period, 51.8% of patients experienced at least one episode of neutropenia. Neutropenia was classified as mild in 50.57% of cases, moderate in 36.88% and severe in 12.54%. GCSF treatment was indicated in 23.28% of patients, with a mean dose of 3.53 units. No statistically significant association was observed between neutropenia or its severity and the development of acute rejection, CLAD or overall survival. However, the patients who received GCSF treatment had a higher mortality rate compared to those who did not. Sixteen patients (5.25%) developed infections during neutropenia, with bacterial infections being the most common.
Neutropenia is common in the first 18 months after lung transplantation and most episodes are mild. We did not find an association between neutropenia and acute rejection, CLAD, or mortality. However, the use of GCSF were associated with worse post-transplant survival.
背景/目的：中性粒细胞减少症是接受免疫抑制治疗和抗菌预防的实体器官移植（SOT）受者的常见并发症。然而，关于肺移植受者（LTR）中性粒细胞减少症的频率和影响的研究有限。我们的目的是分析中性粒细胞减少症的频率、移植后 18 个月内使用粒细胞集落刺激因子（GCSF）治疗的需求及其与急性排斥反应、慢性移植物功能障碍（CLAD）、总生存率和感染发展的关系。
本观察性和回顾性研究纳入了 2009 年至 2019 年间接受肺移植的 305 例患者，术后前 18 个月每季度进行门诊随访。
在此期间，51.8%的患者至少经历过一次中性粒细胞减少症。中性粒细胞减少症分为轻度（50.57%）、中度（36.88%）和重度（12.54%）。23.28%的患者需要使用 GCSF 治疗，平均剂量为 3.53 单位。中性粒细胞减少症或其严重程度与急性排斥反应、CLAD 或总生存率之间无统计学显著相关性。然而，接受 GCSF 治疗的患者死亡率高于未接受治疗的患者。16 名患者（5.25%）在中性粒细胞减少症期间发生感染，其中细菌感染最为常见。
肺移植后 18 个月内中性粒细胞减少症很常见，大多数为轻度。我们没有发现中性粒细胞减少症与急性排斥反应、CLAD 或死亡率之间存在关联。然而，GCSF 的使用与移植后生存质量下降有关。
