Granulocyte colony-stimulating factor therapy is associated with a reduced incidence of acute rejection episodes or allograft vasculopathy in heart transplant recipients
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Granulocyte colony-stimulating factor therapy is associated with a reduced incidence of acute rejection episodes or allograft vasculopathy in heart transplant recipients. / Vrtovec, B; Haddad, F; Pham, M; Deuse, T; Fearon, W F; Schrepfer, S; Leon, S; Vu, T; Valantine, H; Hunt, S A.
In: TRANSPL P, Vol. 45, No. 6, 21.08.2013, p. 2406-2409.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Granulocyte colony-stimulating factor therapy is associated with a reduced incidence of acute rejection episodes or allograft vasculopathy in heart transplant recipients
AU - Vrtovec, B
AU - Haddad, F
AU - Pham, M
AU - Deuse, T
AU - Fearon, W F
AU - Schrepfer, S
AU - Leon, S
AU - Vu, T
AU - Valantine, H
AU - Hunt, S A
N1 - Copyright © 2013 Elsevier Inc. All rights reserved.
PY - 2013/8/21
Y1 - 2013/8/21
N2 - BACKGROUND: We evaluated the potential effects of granulocyte colony-simulating factor (G- CSF) on the incidence of rejection and allograft vasculopathy in heart transplant recipients.METHODS: Of 247 patients undergoing heart transplantation from 2000 to 2007, 52 (21%) developed leukopenia (white blood cell [WBC] <2.5 × 10(9) cells/L) in the absence of active infection, rejection, or malignancy. In 24 (46%) patients a clinical decision was made to treat the leukopenia with G-CSF (G-CSF group), and 28 (54%) Patients received no G-CSF (non-GCSF group). Patients followed up for 1 year after the period of leukopenia were assessed for allograft vasculopathy and acute rejection incidence.RESULTS: At baseline, the G-CSF group and the non-GCSF group did not differ in age, gender, race, heart failure etiology, creatinine, left ventricular ejection fraction (LVEF) or immunosupressive regimen. During 1-year follow-up there were no deaths in the G-CSF group, and 1 death in the non-GCSF group (P = .34). The incidence of rejection or progressive allograft vasculopathy was lower in the G-CSF group when compared with the non-GCSF group (2 [8%] vs 15 [53%]; P < .01). Multivariate analysis identified both prior rejection episodes and G-CSF therapy as factors associated with the combined end-point of rejection or progressive allograft vasculopathy (odds ratio [OR] = 7.89 [1.67-37.2] and OR = 0.09 [0.02-0.52], respectively).CONCLUSIONS: G-CSF therapy appears to be associated with a decreased incidence of acute rejection episodes or allograft vasculopathy in heart transplant recipients, suggesting a potential immunomodulatory effect of G-CSF.
AB - BACKGROUND: We evaluated the potential effects of granulocyte colony-simulating factor (G- CSF) on the incidence of rejection and allograft vasculopathy in heart transplant recipients.METHODS: Of 247 patients undergoing heart transplantation from 2000 to 2007, 52 (21%) developed leukopenia (white blood cell [WBC] <2.5 × 10(9) cells/L) in the absence of active infection, rejection, or malignancy. In 24 (46%) patients a clinical decision was made to treat the leukopenia with G-CSF (G-CSF group), and 28 (54%) Patients received no G-CSF (non-GCSF group). Patients followed up for 1 year after the period of leukopenia were assessed for allograft vasculopathy and acute rejection incidence.RESULTS: At baseline, the G-CSF group and the non-GCSF group did not differ in age, gender, race, heart failure etiology, creatinine, left ventricular ejection fraction (LVEF) or immunosupressive regimen. During 1-year follow-up there were no deaths in the G-CSF group, and 1 death in the non-GCSF group (P = .34). The incidence of rejection or progressive allograft vasculopathy was lower in the G-CSF group when compared with the non-GCSF group (2 [8%] vs 15 [53%]; P < .01). Multivariate analysis identified both prior rejection episodes and G-CSF therapy as factors associated with the combined end-point of rejection or progressive allograft vasculopathy (odds ratio [OR] = 7.89 [1.67-37.2] and OR = 0.09 [0.02-0.52], respectively).CONCLUSIONS: G-CSF therapy appears to be associated with a decreased incidence of acute rejection episodes or allograft vasculopathy in heart transplant recipients, suggesting a potential immunomodulatory effect of G-CSF.
KW - Acute Disease
KW - Adult
KW - Aged
KW - Allografts
KW - California/epidemiology
KW - Chi-Square Distribution
KW - Coronary Artery Disease/epidemiology
KW - Female
KW - Graft Rejection/epidemiology
KW - Granulocyte Colony-Stimulating Factor/therapeutic use
KW - Heart Transplantation/adverse effects
KW - Humans
KW - Immunologic Factors/therapeutic use
KW - Incidence
KW - Leukocyte Count
KW - Leukopenia/blood
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Odds Ratio
KW - Retrospective Studies
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1016/j.transproceed.2013.01.106
DO - 10.1016/j.transproceed.2013.01.106
M3 - SCORING: Journal article
C2 - 23953556
VL - 45
SP - 2406
EP - 2409
JO - TRANSPL P
JF - TRANSPL P
SN - 0041-1345
IS - 6
ER -
