White blood cells play a“Main force” role in defending the body against infection. When bacteria invade, white blood cells will be“Led” by various chemokines to the site of bacterial invasion, surround and engulf the germs. Leukopenia is a common complication after kidney transplantation. It usually indicates that the immune system is over-suppressed. If it is not handled properly, it is easy to be complicated by infection, which can lead to loss of graft function and even life-threatening.
Today, we’re going to talk about the leukopenia after a kidney transplant.
What’s a leukopenia?
White blood cells (WBCS) are an important group of blood cells in the peripheral blood. They are not a homogeneous group, but a collection of granulocytes, monocytes, and lymphocyte. In normal people, the number of white blood cells in the peripheral blood is (4.0-10.0) × 109L. A continuous count of less than 4.0 × 109L is called a leukopenia. They were classified as mild, moderate, severe, and critical according to the degree of leukopenia: mild with a white blood cell count of (3.0ー4.0) × 109/L and moderate with a white blood cell count of (2.0ー3.0) × 109/L, white blood cell count decreased to (1.0ー2.0) × 109/L was severe, white blood cell count decreased to less than 1.0 × 109/l was critical. Fatigue and dizziness are the most common symptoms of leukopenia, as well as loss of appetite, limb weakness, low fever, chills and palpitations, often high fever, chills, headache, fatigue or extreme weakness, and recurrent oral ulcers. A small number of patients have no symptoms and are often ignored by doctors and patients. They are diagnosed with other diseases. At this time, the total number of white blood cells should be checked repeatedly. If the total number of white blood cells is continuously lower than 4.0 × 109L, it can be diagnosed as leukopenia.
Common causes of leukopenia after kidney transplantation?
The most common cause of leukopenia after kidney transplantation is myelosuppression with high doses of immunosuppressive drug, mainly including mycophenolate mofetil (such as Xiaoxi, Meave) , alemtuzumab, antithymoglobulin, etc. . Patients with high sensitivity and poor tolerance to these drugs are prone to myelosuppression, resulting in leukopenia. In addition, viral infections (CMV, parvovirus B19, HPV, epstein-barr virus) , antibiotics (Linezolid, chloramphenicol) and antiviral drug (valganciclovir, ganciclovir) can also cause leukopenia after kidney transplantation.
How do you deal with leukopenia after a kidney transplant?
The key to treating leukopenia is to get rid of the cause. Immunosuppressants should be adjusted or discontinued immediately if they are caused by immunosuppressive drug, discontinued if they are caused by antibiotics or antiviral drug, and aggressive anti-infective therapy if they are caused by viral infections. At the same time, you can use a variety of leucocyte-enhancing drugs such as leucogen, shark liver alcohol, lithium carbonate, vitamin B, etc. , if necessary, should be given CSF3. For patients with a longer course of disease, leukopenia is not obvious, and bone marrow examination showed no obvious Granulopoiesis, mainly regular follow-up, remove concerns, do not need too much dependence on drugs.
Here to remind you after kidney transplantation patients: once found leukopenia or related symptoms, we must actively seek medical help, timely diagnosis and treatment; When diagnosed with leukopenia, avoid overwork, pay attention to climate change, change clothing and clothing in a timely manner, and pay attention to preventing infection.
Article, edited | Sun Jiajia, photo | Nico Ding
This article is an original article of”Kidney Transplantation, sun yat-sen hospital, Fudan University”. It is reproduced with the author’s permission and marked with the source. Care about the kidney, from the concern”Fudan University affiliated Zhongshan Hospital Kidney Transplant” public wechat start, you can also click [ read the original ] , view肾移植术后的营养治疗和饮食管理
