Role of donor leukocyte chimerism in establishing the etiology of neutropenia after liver transplantation

Background, The quantitation of donor leukocyte chimerism may aid in establ ishing the etiology of neutropenia after liver transplantation. Methods. The incidence and clinical and laboratory characteristics of sever e neutropenia were studied in adults who have undergone liver transplantati on at our institution over the last 4 years. Results. Severe neutropenia developed in 5 of 156 patients (3%). The clinic al and pathological features were nonspecific, In two patients with a delay ed diagnosis of graft-versus-host disease (GVHD), donor leukocytes comprise d greater than or equal to 50% of the circulating peripheral blood mononucl ear cells. In a third patient, an earlier diagnosis of GVBD was suspected o n the basis of a donor leukocyte count of 3-10% in the peripheral blood. In contrast, donor leukocyte chimerism was less than or equal to 0.01% in two patients with probable drug-induced neutropenia Conclusions. The determination of donor leukocyte chimerism has an importan t role in the investigation of neutropenia after liver transplantation, all owing early diagnosis and treatment of GVHD.