title: Induction therapy, tacrolimus plasma concentration, and duration if intensive care unit stay are risk factors for peripheral leucopenia following heart transplantation.
abstract: BACKGROUND
  Although survival among heart recipients has increased, a limiting factor is chronic adverse effects of immunosuppression therapy.
  
  
  METHODS
  We performed a retrospective analysis of 22 patients (19 men and 3 women) with a mean age of 48 ± 12 years who underwent orthotropic heart transplantation. There were 20 (91%) patients who received induction therapy (basiliximab, Simulect, Novartis Europharm Limited). All patients were treated with standard triple immunosuppressive regimen (tacrolimus, mycophenolate mofetil, and steroids).
  
  
  RESULTS
  Patients were divided into 2 groups according to postoperative peripheral cytopenia diagnosis. There were 16 (73%) in the cytopenic group and 6 (27%) in the non-cytopenic group. Mean time of peripheral leucopenia detection was 65 ± 13 days following surgery. The blood leucocyte count was 0.98 ± 0.2 × 10(3)/mm(3) vs. 5.85 ± 0.9 × 10(3)/mm(3) in patients with peripheral cytopenia compared to non-cytopenic patients (p<0.01). There was a statistically important difference in duration of intensive care unit stay between the 2 groups (p<0.01). A correlation between tacrolimus serum concentration and risk for leucopenia was also detected (p<0.05).
  
  
  CONCLUSIONS
  Basiliximab administration as induction therapy, tacrolimus serum concentration, and duration of intensive care unit stay are risk factors for leucopenia.
authors.affiliation: Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Urbanowicz
authors.affiliation: Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Straburzyńska-Migaj
authors.affiliation: Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Aneta
authors.initials: A
authors.lastname: Klotzka
authors.affiliation: Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Baszyńska-Wachowiak
authors.affiliation: Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Misterski
authors.affiliation: Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Grajek
authors.affiliation: Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Jemielity
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D000077552:Basiliximab; D003422:Critical Care; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000097:blood*; D060828:Induction Chemotherapy / Q000009:adverse effects; D007902:Length of Stay; D007970:Leukopenia / Q000097:blood / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011993:Recombinant Fusion Proteins / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects / Q000097:blood*
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D016559:Tacrolimus