{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:17:21Z","timestamp":1790371041935,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T00:00:00Z","timestamp":1588204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Pneumocystis jirovecii<\/jats:italic> pneumonia (PcP) remains a life\u2010threatening opportunistic infection after solid organ transplantation, even in the era of Pneumocystis prophylaxis. The association between risk of developing PcP and low CD4<jats:sup>+<\/jats:sup> T cell counts has been well established. However, it is unknown whether lymphopenia in the context of post\u2010renal transplant PcP increases the risk of mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We carried out a retrospective analysis of a cohort of kidney transplant patients with PcP (n\u00a0=\u00a049) to determine the risk factors for mortality associated with PcP. We correlated clinical and demographic data with the outcome of the disease. For CD4<jats:sup>+<\/jats:sup> T cell counts, we used the Wilcoxon rank sum test for in\u2010hospital mortality and a Cox proportional\u2010hazards regression model for 60\u2010day mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In univariate analyses, high CRP, high neutrophils, CD4<jats:sup>+<\/jats:sup> T cell lymphopenia, mechanical ventilation, and high acute kidney injury network stage were associated with in\u2010hospital mortality following presentation with PcP. In a receiver\u2010operator characteristic (ROC) analysis, an optimum cutoff of \u2264200 CD4<jats:sup>+<\/jats:sup> T cells\/\u00b5L predicted in\u2010hospital mortality, CD4<jats:sup>+<\/jats:sup> T cell lymphopenia remained a risk factor in a Cox regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low CD4<jats:sup>+<\/jats:sup> T cell count in kidney transplant recipients is a biomarker for disease severity and a risk factor for in\u2010hospital mortality following presentation with PcP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13877","type":"journal-article","created":{"date-parts":[[2020,4,11]],"date-time":"2020-04-11T18:39:22Z","timestamp":1586630362000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["CD4<sup>+<\/sup> T cell lymphopenia predicts mortality from <i>Pneumocystis<\/i> pneumonia in kidney transplant patients"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4759-717X","authenticated-orcid":false,"given":"Tilo","family":"Freiwald","sequence":"first","affiliation":[{"name":"Medical Clinic III Department of Nephrology University Hospital Frankfurt Goethe\u2010University Frankfurt Germany"},{"name":"Immunoregulation Section National Institute of Diabetes and Digestive and Kidney Diseases Bethesda MD USA"},{"name":"Complement and Inflammation Research National Heart Lung and Blood Institute National Institutes of Health Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"B\u00fcttner","sequence":"additional","affiliation":[{"name":"Medical Clinic III Department of Nephrology University Hospital Frankfurt Goethe\u2010University Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nardos T.","family":"Cheru","sequence":"additional","affiliation":[{"name":"Immunoregulation 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and Diabetology Carl\u2010Thiem Hospital Cottbus Cottbus Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Asbe\u2010Vollkopf","sequence":"additional","affiliation":[{"name":"Medical Clinic III Department of Nephrology University Hospital Frankfurt Goethe\u2010University Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gundolf","family":"Sch\u00fcttfort","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Frankfurt Goethe\u2010University Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkmar","family":"Jacobi","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospital Frankfurt Goethe\u2010University Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Institute for Biostatistics and Mathematical 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