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Abstract: FR-PO849

Healthcare Resource Utilization Associated With Post-Transplant Neutropenia and Leukopenia Among Kidney Transplant Recipients: A Real-World Evidence Study

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Merchant, Sanjay, Merck and Co Inc, Rahway, New Jersey, United States
  • Raval, Amit, Merck and Co Inc, Rahway, New Jersey, United States
  • Turzhitsky, Vladimir, Merck and Co Inc, Rahway, New Jersey, United States
  • Fazio-Eynullayeva, Elnara, TriNetX LLC, Cambridge, Massachusetts, United States
  • Jin, Harry, TriNetX LLC, Cambridge, Massachusetts, United States
Background

Kidney transplant recipients (KTRs) are often prescribed medications to reduce the risk of cytomegalovirus (CMV) infection, including valganciclovir/ganciclovir (V/G), however, use of V/G increases the risk of developing post-transplant neutropenia (PTN) and post-transplant leukopenia (PTL). Real-world evidence describing health care resource utilization (HCRU) associated with PTN/PTL are limited.

Methods

This retrospective cohort study utilized the TriNetX Dataworks – USA Network, a federated network of de-identified electronic health record data for 82.5 million patients in the US. KTRs who were treated with V/G between January 1, 2012, and September 30, 2020, were included in this analysis. PTN was defined as absolute neutrophil count <1500/μL, and PTL was defined as white blood cell count <3,500/μL. We analyzed HCRU among KTRs and compared HCRU between those with and without PTN/PTL.

Results

Overall, 8,791 patients had a mean age of 52.8 years, 40.7% female, 41.6% White, and 32.6% Black. A total of 3,383 patients (38.5%) developed PTN and 6,127 patients (69.7%) developed PTL. The mean (SD) time from transplantation to the development of PTN or PTL were 5.6 (3.1) months and 6.4 (3.7) months, respectively. Among the 3,383 patients who developed PTN, 61.5% had inpatient admission(s), 16.5% had PTN-related hospitalization, 36.7% had emergency room visit(s), and 38.9% were treated with G-CSF. Similarly, among the 6,127 patients who developed PTL, 60.8% had inpatient admission(s), 24.5% had PTL-related hospitalization, 34.9% had emergency room visit(s), and 22.8% were treated with G-CSF.

Conclusion

The results of the study suggest that V/G treated KTRs are at elevated risk of developing PTN/PTL, both of which are associated with increased HCRU. Further research is needed to inform the development of interventions designed to decrease the risk of suboptimal health outcomes and HCRU among KTRs.

Health care resource utilization among KTRs
 With PTN (n=3,383)Without PTN (n=5,408)P-valueWith PTL (n=6,127)Without PTL (n=2,664)P-value
Inpatient admission post-transplant2,080 (61.5%)2,990 (55.3%)<0.0013,724 (60.8%)1,346 (50.5%)<0.001
Neutropenia/Leukopenia-related hospitalization555 (16.5%)58 (1.1%)<0.0011,502 (24.5%)89 (3.3%)<0.001
Emergency room visit1,242 (36.7%)1,689 (31.2%)<0.0012,138 (34.9%)793 (29.8%)<0.001
Granulocyte colony-stimulating factor (G-CSF) use1,316 (38.9%)195 (3.61%)<0.0011,398 (22.8%)113 (4.2%)<0.001

Funding

  • Commercial Support