ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2014
Pretransplant lymphopenia is a novel prognostic factor in cytomegalovirus and noncytomegalovirus invasive infections after liver transplantation.
Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 49 citations in OpenAlex.
- Evaluation of Global Immune Biomarkers to Predict Infections in Lung Transplant Recipients.Clinical transplantation · 2026Article
- Sex Differences in Alloimmunity and Other Immunological Considerations in Organ Transplantation.Immunological reviews · 2026Review
- Sex- and Age-based Comparison of Key Clinical Markers of Immunity After Heart and Kidney Transplantation.Transplantation direct · 2025Article
- Risk factors affecting the incidence of CMV infection in recipients after living donor liver transplantation.BMC gastroenterology · 2025Article
- Neutrophil-derived ratios as predictors of short-term mortality in HBV-associated decompensated cirrhosis.BMC gastroenterology · 2025Article
- Immune monitoring and risk of infection in pediatric liver transplantation: a prospective study.Frontiers in immunology · 2025Article
- Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients.Transplant international : official journal of the European Society for Organ Transplantation · 2025Article
- A Clinical Model to Predict the Occurrence of Select High-risk Infections in the First Year Following Heart Transplantation.Transplantation direct · 2023Article
- Article
- Utility of the Interferon-Gamma Enzyme-Linked Immunosorbent Spot Assay to Predict Risk of Cytomegalovirus Infection in Kidney Transplant Recipients.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- Association Between Lymphopenia at 1 Month Posttransplant and Infectious Outcomes or Death in Heart Transplant Recipients.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Immunosuppressive Agents and Infectious Risk in Transplantation: Managing the "Net State of Immunosuppression".Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Review
- General and Intensive Care Outcomes for Hospitalized Patients With Solid Organ Transplants With COVID-19.Journal of intensive care medicine · 2021Article
- Post-transplant absolute lymphocyte count predicts early cytomegalovirus infection after heart transplantation.Scientific reports · 2021Article
- The Contribution of Serum Complement Component 3 Levels to 90-Day Mortality in Living Donor Liver Transplantation.Frontiers in immunology · 2021Article
- Article
- Clinical, imaging, endoscopic findings, and management of patients with CMV colitis: a single-institute experience.Emergency radiology · 2020Article
- Acute rejection after liver transplantation is less common, but predicts better prognosis in HBV-related hepatocellular carcinoma patients.Hepatology international · 2020Article
- Epidemiology and Outcomes of Early-Onset and Late-Onset Adenovirus Infections in Kidney Transplant Recipients.Open forum infectious diseases · 2019Article
- Influence of Calcineurin Inhibitor and Sex on Mycophenolic Acid Pharmacokinetics and Adverse Effects Post-Renal Transplant.Journal of clinical pharmacology · 2019Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
Infection after liver transplantation (LT) remains a leading cause of morbidity and mortality. The risk of infection after LT is highest in those who are most immunosuppressed, but to date, no standard blood marker of one's degree of immunosuppression or risk index has been established. The purpose of this study was to determine whether pretransplant lymphopenia (absolute lymphocyte count < 500 cells/mm3 within 24 hours before LT) is a candidate marker of immunosuppression and could be useful in predicting the risk of cytomegalovirus (CMV) disease and non-CMV invasive infections after LT. Data were extracted from medical records for all primary, solitary LT procedures performed at Tufts Medical Center from 1999 to 2009. Two hundred seventy-six patients had sufficient data to be included in the analysis. Among these patients, 52% developed CMV or non-CMV invasive infections within 5 years of LT. Within 2 years, 23 (8%) had CMV disease, and 103 (37%) at least 1 non-CMV invasive infection. More lymphopenic patients than nonlymphopenic patients developed CMV (21% versus 4%, P < 0.001) and non-CMV invasive infections (50% versus 33%, P = 0.02). In a multivariate survival analysis, pretransplant lymphopenia was the strongest independent predictor of CMV disease [hazard ratio (HR) = 5.52, 95% confidence interval (CI) = 2.31-13.1, P = 0.001] after adjustments for known risk factors, including CMV serostatus (HR = 4.72, 95% CI = 2.01-11.1, P < 0.001). Both pretransplant lymphopenia (HR = 1.64, 95% CI = 1.14-2.53, P = 0.03) and CMV (HR = 2.93, 95% CI = 1.23-6.92, P = 0.02) independently predicted non-CMV infections. Our results suggest that pretransplant lymphopenia is a novel independent predictor of both CMV disease and non-CMV invasive infections after LT and is a candidate marker of immunosuppression in LT recipients.
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