Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients
Infections remain a main cause of morbidity and mortality following orthotopic liver transplantation (OLT). Patients with end-stage liver cirrhosis exhibit a deregulation of their immune response, making them more susceptible to infections. From a prospective database, we retrospectively assessed th...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-05-01
|
| Series: | Transplant International |
| Subjects: | |
| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14372/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849313269342273536 |
|---|---|
| author | Mikhael Giabicani Mikhael Giabicani Clara Timsit Léa Copelovici Pauline Devauchelle Marion Guillouët Marina Hachouf Sylvie Janny Juliette Kavafyan Stéphanie Sigaut Tristan Thibault-Sogorb Safi Dokmak Federica Dondero Mickael Lesurtel Mickael Lesurtel Olivier Roux François Durand François Durand Emmanuel Weiss Emmanuel Weiss |
| author_facet | Mikhael Giabicani Mikhael Giabicani Clara Timsit Léa Copelovici Pauline Devauchelle Marion Guillouët Marina Hachouf Sylvie Janny Juliette Kavafyan Stéphanie Sigaut Tristan Thibault-Sogorb Safi Dokmak Federica Dondero Mickael Lesurtel Mickael Lesurtel Olivier Roux François Durand François Durand Emmanuel Weiss Emmanuel Weiss |
| author_sort | Mikhael Giabicani |
| collection | DOAJ |
| description | Infections remain a main cause of morbidity and mortality following orthotopic liver transplantation (OLT). Patients with end-stage liver cirrhosis exhibit a deregulation of their immune response, making them more susceptible to infections. From a prospective database, we retrospectively assessed the ability of preoperative lymphopenia, as a marker of this immune dysregulation, to predict the occurrence of early postoperative bacterial infections during post-OLT ICU hospitalization in patients with cirrhosis. Between January 2011 and December 2021, we included 445 patients. Post-OLT infections occurred in 92 patients (21%) and were mainly represented by bacteriemia (39%), pneumonia (37%) and surgical site infection (30%). Preoperative lymphocyte count ≤1.150 × 109/L was identified as an independent risk factor, as well as preoperative encephalopathy, intraoperative RBC transfusion >2 and intraoperative maximum norepinephrine dose >0.5 μg.kg−1.min−1 (all p < 0.05). Bootstrap analysis validated these results (p < 0.05). The risk factors were integrated into the PRELINFO score which was associated with the risk of infection (p < 0.05). The depth of preoperative lymphopenia was also associated with the risk of infection and postoperative correction of lymphopenia was slower in patients who developed an infection than in those who did not. Preoperative blood lymphocyte count should be incorporated into the assessment of the risk of early post-OLT bacterial infections. |
| format | Article |
| id | doaj-art-256cbddf9b4348d1b66d08d0e6b4b8f7 |
| institution | Kabale University |
| issn | 1432-2277 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Transplant International |
| spelling | doaj-art-256cbddf9b4348d1b66d08d0e6b4b8f72025-08-20T03:52:48ZengFrontiers Media S.A.Transplant International1432-22772025-05-013810.3389/ti.2025.1437214372Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic PatientsMikhael Giabicani0Mikhael Giabicani1Clara Timsit2Léa Copelovici3Pauline Devauchelle4Marion Guillouët5Marina Hachouf6Sylvie Janny7Juliette Kavafyan8Stéphanie Sigaut9Tristan Thibault-Sogorb10Safi Dokmak11Federica Dondero12Mickael Lesurtel13Mickael Lesurtel14Olivier Roux15François Durand16François Durand17Emmanuel Weiss18Emmanuel Weiss19Department of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceCentre de Recherche des Cordeliers, Sorbonne Université, Université, Paris Cité, Inserm, Laboratoire ETREs, Paris, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceDepartement of HPB Surgery & Liver Transplantation, AP-HP, Beaujon Hospital, DMU DIGEST, Université Paris-Cité, Clichy, FranceDepartement of HPB Surgery & Liver Transplantation, AP-HP, Beaujon Hospital, DMU DIGEST, Université Paris-Cité, Clichy, FranceDepartement of HPB Surgery & Liver Transplantation, AP-HP, Beaujon Hospital, DMU DIGEST, Université Paris-Cité, Clichy, FranceUniversité Paris-Cité, Inserm, Centre de Recherche sur l’Inflammation, UMR 1149, Paris, FranceService d’Hépatologie, AP-HP, Hôpital Beaujon, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Clichy, FranceUniversité Paris-Cité, Inserm, Centre de Recherche sur l’Inflammation, UMR 1149, Paris, FranceService d’Hépatologie, AP-HP, Hôpital Beaujon, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Clichy, FranceDepartment of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, and Université Paris Cité, Paris, FranceUniversité Paris-Cité, Inserm, Centre de Recherche sur l’Inflammation, UMR 1149, Paris, FranceInfections remain a main cause of morbidity and mortality following orthotopic liver transplantation (OLT). Patients with end-stage liver cirrhosis exhibit a deregulation of their immune response, making them more susceptible to infections. From a prospective database, we retrospectively assessed the ability of preoperative lymphopenia, as a marker of this immune dysregulation, to predict the occurrence of early postoperative bacterial infections during post-OLT ICU hospitalization in patients with cirrhosis. Between January 2011 and December 2021, we included 445 patients. Post-OLT infections occurred in 92 patients (21%) and were mainly represented by bacteriemia (39%), pneumonia (37%) and surgical site infection (30%). Preoperative lymphocyte count ≤1.150 × 109/L was identified as an independent risk factor, as well as preoperative encephalopathy, intraoperative RBC transfusion >2 and intraoperative maximum norepinephrine dose >0.5 μg.kg−1.min−1 (all p < 0.05). Bootstrap analysis validated these results (p < 0.05). The risk factors were integrated into the PRELINFO score which was associated with the risk of infection (p < 0.05). The depth of preoperative lymphopenia was also associated with the risk of infection and postoperative correction of lymphopenia was slower in patients who developed an infection than in those who did not. Preoperative blood lymphocyte count should be incorporated into the assessment of the risk of early post-OLT bacterial infections.https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14372/fullinfectionlymphopeniacirrhosis associated immune dysfunctionorthotopic liver transplantation (OLT)cirrhosis |
| spellingShingle | Mikhael Giabicani Mikhael Giabicani Clara Timsit Léa Copelovici Pauline Devauchelle Marion Guillouët Marina Hachouf Sylvie Janny Juliette Kavafyan Stéphanie Sigaut Tristan Thibault-Sogorb Safi Dokmak Federica Dondero Mickael Lesurtel Mickael Lesurtel Olivier Roux François Durand François Durand Emmanuel Weiss Emmanuel Weiss Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients Transplant International infection lymphopenia cirrhosis associated immune dysfunction orthotopic liver transplantation (OLT) cirrhosis |
| title | Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients |
| title_full | Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients |
| title_fullStr | Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients |
| title_full_unstemmed | Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients |
| title_short | Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients |
| title_sort | role of lymphopenia in early prediction of infection following orthotopic liver transplantation in cirrhotic patients |
| topic | infection lymphopenia cirrhosis associated immune dysfunction orthotopic liver transplantation (OLT) cirrhosis |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14372/full |
| work_keys_str_mv | AT mikhaelgiabicani roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT mikhaelgiabicani roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT claratimsit roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT leacopelovici roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT paulinedevauchelle roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT marionguillouet roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT marinahachouf roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT sylviejanny roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT juliettekavafyan roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT stephaniesigaut roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT tristanthibaultsogorb roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT safidokmak roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT federicadondero roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT mickaellesurtel roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT mickaellesurtel roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT olivierroux roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT francoisdurand roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT francoisdurand roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT emmanuelweiss roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients AT emmanuelweiss roleoflymphopeniainearlypredictionofinfectionfollowingorthotopiclivertransplantationincirrhoticpatients |