Abstract: TH-PO839
Clinical Outcomes and Health Care Resource Utilization Associated with Post-Transplant Neutropenia Among Kidney Transplant Recipients: A Real-World Evidence Study
Session Information
- Transplantation: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Li, Qinghua, Merck & Co Inc, Rahway, New Jersey, United States
- Turzhitsky, Vladimir, Merck & Co Inc, Rahway, New Jersey, United States
- Moise, Pamela, Merck & Co Inc, Rahway, New Jersey, United States
- Brzozowski, Kaylen, TriNetX LLC, Cambridge, Massachusetts, United States
- Kolobova, Irina, Merck & Co Inc, Rahway, New Jersey, United States
Background
Cytomegalovirus (CMV) remains one of the leading opportunistic infections after kidney transplantation (KT). Valganciclovir is the preferred drug for CMV prophylaxis, but neutropenia limits its use. The objective of this study was to examine the differences in clinical outcomes and HCRU among KT recipients (KTRs) with and without PTN.
Methods
This retrospective cohort study utilized the TriNetX Dataworks – USA Network, a federated network of de-identified electronic health record data for over 86 million patients in the US. Adult KTRs who received their first KT between 1/1/2012 and 9/30/2020 and valganciclovir/ganciclovir within 30 days post-KT were included. PTN was defined by laboratory ANC of <1000 cells/µl. We ran Chi-square tests for categorical variables and t-tests for continuous variables.
Results
Among 8,791 KTRs included in this study, 2,149 (24.4%) developed PTN. Table 1 presents the comparison on clinical and HCRU outcomes. A higher proportion of KTRs with PTN had CMV infections/disease (12.1% vs. 4.4%), other opportunistic infections (e.g., bacterial septicemia (13.1 vs 8.4%)), graft rejection (30.5% vs. 25.8%), graft loss (7.6% vs. 5.2%), new-onset of diabetes mellitus (32.8% vs. 21.5%), and received dialysis (30.5% vs 25.8%) within 1 year post-KT. KTRs with PTN (vs. without) were more like to have hospitalizations (63.1% vs. 55.9%), ER visits (37.5% vs. 32.0%), outpatient visits (mean number of visits: 39.3 vs. 33.0), blood transfusions (23.5% vs. 20.1%), and G-CSF use (54.2% vs. 5.2%).
Conclusion
KTRs with PTN tended to experience more opportunistic infections, worse graft outcomes and higher HCRU. The findings suggest the need for treatment options to reduce the risk of PTN among KTRs to improve clinical outcomes and reduce HRCU post-KT.
Funding
- Commercial Support – Merck & Co. Inc