Impact of hepatitis serology on development of leukopenia after solid organ transplantation.
BACKGROUND
Homologous organ transplantation is an accepted therapeutic modality for end-stage disease of the kidney and liver. In posttransplantation periods leukopenia is a common problem with a wide range of differential diagnoses. Not only can it lead to an increased incidence of infections, but preclude the use of adequate immunosuppressive therapy and antimicrobial regimens because of their potential leukopenic side effects. One reason for leukopenia is viral hepatitis, which is frequently seen in transplant recipients. Herein this report, we searched for the relationship of leukopenic bouts among kidney and liver transplantation recipients to hepatitis serology.


METHODS
We retrospectively evaluated the records of 569 patients who received solid transplants between January 1996 and October 2006. Because 27 patients did not come for follow-up examinations, their data were excluded, and 14 patients had 2 transplantations, yielding 556 primary transplantation cases for leukopenic attacks.


RESULTS
Leukopenic attacks showed a strong relationship with hepatitis B virus (HBV) infection, but were independent of HBV DNA status (P = .002). No relationship with hepatitis C virus (HCV) infection status was found.


CONCLUSIONS
Leukopenia is a common, important complication that can be seen during the posttransplantation period of recipients affecting both mortality and morbidity. HBV infection is a risk factor for development of leukopenia after transplantation. Adequate treatment of HBV infection in transplant recipients is important to obtain leukocyte counts in the normal range, allowing easier and safe antibacterial and immunosuppressive therapy in the posttransplantation period.
Karakus
S
S
Baskent University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Baskent University, Ankara, Turkey. sema_karakus@hotmail.com
Arin
B E
BE
Arat
Z
Z
Karakayali
H
H
Haberal
M
M
D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology*; D006515:Hepatitis B virus / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D007970:Leukopenia / Q000453:epidemiology*; D017093:Liver Failure / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
D004279:DNA, Viral