Table 1.
Characteristics of heart transplant recipients with and without neutropenia
| Total, N=278 | Neutropenia, N=84 | No Neutropenia, N=194 | |
|---|---|---|---|
| Pre-transplant | |||
| Male, N (%) | 201 (72.3) | 59 (70.2) | 142 (73.2) |
| Hispanic | 27 (9.7) | 7 (8.3) | 20 (10.3) |
| White | 228 (82) | 73 (86.9) | 155 (79.9) |
| Black | 18 (6.5) | 3 (3.6) | 15 (7.7) |
| Asian | 5 (1.8) | 1 (1.2) | 4 (2.1) |
| Age, years , mean (SD) | 52.6 (12.0) | 53.5 (11.8) | 52.3 (12.0) |
| BMI, kg/m2 | 27.7 (5.5) | 28.4 (6.1) | 27.4 (5.2) |
| †Baseline WBC, cells /mm3 | 8.1 (2.9) | 7.5 (2.3) | 8.3 (3.1) |
| Baseline ANC, cells/mm3 | 5.5 (2.6) | 5.1 (1.9) | 5.7 ‡(2.9) |
| Baseline Creatinine, mg/dL | 1.2 (0.4) | 1.3 (0.5) | 1.2 (0.4) |
| §Baseline GFR <= 60, mL/min/1.73 m2 | 111 (39.9) | 84 (50) | 69 (35.6) |
| CKD, N (%) | 83 (29.9) | 28 (33.3) | 55 (28.4) |
| Diabetes | 95 (34.2) | 28 (33.3) | 67 (34.5) |
| Solid Tumor | 14 (5) | 2 (2.4) | 12 (6.2) |
| Heme Malignancy | 18 (6.5) | 2 (2.4) | 16 (8.2) |
| Autoimmune Disease | 10 (3.6) | 3 (3.6) | 7 (3.6) |
| Ischemic Cardiomyopathy | 101 (36.3) | 32 (38.1) | 69 (35.6) |
| Non-Ischemic Cardiomyopathy | 179 (64.4) | 52 (61.9) | 127 (65.5) |
| Giant Cell myocarditis | 5 (1.8) | 3 (3.6) | 2 (1) |
| Durable VAD | 181 (65.1) | 62 (73.8) | 119 (61.3) |
| IABP | 14 (5) | 3 (3.6) | 11 (5.7) |
| Extracorporeal Surgically Implanted MCS | 2 (0.7) | 1 (1.2) | 1 (0.5) |
| ECMO | 1 (0.4) | 0 (0) | 1 (0.01) |
| Post-Transplant | |||
| CMV serostatus | |||
| CMV D+R− | 85 (30.6) | 37 (44) | 48 (24.7) |
| CMV D+R+ | 63 (22.7) | 19 (22.6) | 44 (22.7) |
| CMV D−R+ | 56 (20.1) | 13 (15.5) | 43 (22.2) |
| CMV D−R− | 74 (26.6) | 15 (17.9) | 59 (30.4) |
| Hemodialysis | 30 (10.8) | 12 (14.3) | 18 (9.3) |
| Hospital length of stay, days, median (25%-75%) | 14 (11- 18) | 14 (11.5 - 19) | 14 (11- 18) |
| Outcomes Post-Transplant; Pre and Post Neutropenia | |||
| Infection | 74 (26.6) | 34 (40.5) | 40 (20.1) |
| Rejection | 65 (23.4) | 21 (25) | 44 (22.7) |
| Death | 13 (4.7) | 4 (4.8) | 9 (4.6) |
| Medications at discharge | |||
| Mycophenolate | 265 (95.3) | 81 (96.4) | 184 (94.8) |
| Sirolimus | 11 (4) | 4 (4.8) | 7 (3.6) |
| Cyclosporine | 56 (20.1) | 7 (8.3) | 49 (25.3) |
| Tacrolimus | 217 (78.1) | 72 (85.7) | 145 (74.7) |
| TMP-SMX | 235 (84.5) | 70 (83.3) | 165 (85.1) |
| Ganciclovir or Valganciclovir | 202 (72.7) | 68 (81) | 134 (69.1) |
| ¶ Medications During Neutropenia Period | |||
| Tacrolimus | 216 (79.1) | 74 (88.1) | 142 (75.1) |
| Sirolimus | 7 (2.5) | 3 (3.6) | 4 (2.1) |
| Cyclosporine | 50 (18) | 7 (8.3) | 43 (22.2) |
| Mycophenolate | 251 (91.9) | 77 (91.7) | 174 (92.1) |
| Azathioprine | 7 (2.5) | 3 (3.6) | 4 (2.1) |
| Anti-T-cell agent | 38 (14) | 18 (21.7) | 20 (10.6) |
| TMP-SMX | 220 (80.6) | 62 (73.8) | 158 (83.6) |
| Dapsone | 19 (6.8) | 10 (11.9) | 9 (4.6) |
| Ganciclovir or Valganciclovir | 144 (52.7) | 57 (67.9) | 87 (46) |
| G-CSF | 51 (18.3) | 47 (56) | 4 (2.1) |
Abbreviations: BMI: body mass index, WBC: white blood cell, ANC: absolute neutrophil count, GFR: glomerular filtration rate, CKD: chronic kidney disease, VAD: ventricular assist device, IABP: intra-aortic balloon pump, MCS: mechanical cardiac support, ECMO: extracorporeal membrane oxygenation, CMV: Cytomegalovirus, D: donor, R: recipient, TMP-SMX: trimethoprim sulfamethoxazole, G-CSF: granulocyte colony stimulating factor.
†
baseline was within 24 hours before transplant
‡
missing N=38
§
CKD-EPI equation [30]
¶
defined as 4 weeks before and 2 weeks after date of onset of ANC ≤ 1000 cells/mm3