ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Association Between Lymphopenia at 1 Month Posttransplant and Infectious Outcomes or Death in Heart Transplant Recipients.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- 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
- Adenosine signaling promotes double-negative T-cell anticancer responses in conditions of CD8 T-cell lymphopenia.Blood immunology & cellular therapy · 2026Article
- Predictors of mortality in a Chinese medical ICU: a focus on ICU-acquired bloodstream infections.BMC infectious diseases · 2026Article
- Sex- and Age-based Comparison of Key Clinical Markers of Immunity After Heart and Kidney Transplantation.Transplantation direct · 2025Article
- Chronic and reactivated dengue infection in an immunocompromised host: insights from a case report.Tropical medicine and health · 2025Article
- Risk of cytomegalovirus infection and subsequent allograft failure after pancreas transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- Performance of a Global Functional Assay Based on Interferon-γ Release to Predict Infectious Complications and Cancer After Kidney Transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2024Article
- Current and emerging tools for simultaneous assessment of infection and rejection risk in transplantation.Frontiers in immunology · 2024Review
- A Clinical Model to Predict the Occurrence of Select High-risk Infections in the First Year Following Heart Transplantation.Transplantation direct · 2023Article
- BK polyomavirus DNAemia in pancreas transplant recipients compared to pancreas-kidney recipients.Clinical transplantation · 2023Article
- Cytomegalovirus Cell-Mediated Immunity: Ready for Routine Use?Transplant international : official journal of the European Society for Organ Transplantation · 2023Review
- Difference in absolute lymphocyte count among male and female heart transplant recipients.Clinical transplantation · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundCell-mediated immunity is a specific target of several medications used to prevent or treat rejection in orthotopic heart transplantation. Low absolute lymphocyte count (ALC) has potential to be a useful and accessible clinical indicator of overall infection risk. Though some studies have demonstrated this association in other transplant populations, it has not been assessed in heart transplant recipients.
methodsA single-center retrospective cohort study examined adult heart transplant recipients transplanted between 2000 and 2018. The exposure of interest was ALC ≤0.75 × 103 cells/µL at 1 month posttransplant, and the primary endpoint was a composite outcome of infection (including cytomegalovirus [CMV], herpes simplex I/II or varicella zoster virus [HSV/VZV], bloodstream infection [BSI], invasive fungal infection [IFI]) or death occurring after 1 month and before 1 year posttransplant. A multivariable Cox proportional hazards model was created to control for confounders identified using clinical judgment and statistical criteria.
resultsOf 375 subjects analyzed, 101 (27%) developed the composite outcome (61 CMV, 3 HSV/VZV, 19 BSI, 10 IFI, 8 deaths). Lymphopenia (ALC ≤0.75 × 103 cells/µL) at 1 month was associated with a >2-fold higher rate of the composite outcome (hazard ratio [HR], 2.26 [95% confidence interval {CI}, 1.47-3.46]; P < .001) compared to patients without lymphopenia at 1 month. After adjustment for confounding variables, the presence of lymphopenia remained statistically significantly associated with the composite outcome (HR, 1.72 [95% CI, 1.08-2.75]; P = .02).
conclusionsALC measured at 1 month after heart transplant is associated with an increased risk of infectious outcomes or death in the ensuing 11 months. This is a simple, accessible laboratory measure.
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